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LIBRARY
OF THE
UNIVERSITY OF NORTH CAROLINA,
Endowed by the Dialectic and Philanthropic Societies.
Alcove Shelf
VJ/\
SIXTH BIENNIAL EEPOKT
NORTH CAROLINA
BOARD OF HEALTH.
1895-1896.
WINSTON:
M. I. & J. C. Stewart, Pdblic Printers and Binders.
1897.
aiD'f^d
MEMBERS OF THE BOARD.
ELECTED BY THE MEDICAL SOCIETY OF THE STATE OF
NORTH CAROLINA.
Oeorge GriLLETT Thomas, M. D., President Wilmington.
Term Expii'es 1897.
S. Wbstray Battle, M. D Asheville.
Term Expires 1897.
W. H. Harrell, M. D Williamston.
Term Expires 1897.
John Whitehead, M. D Salisbury.
Term Expires 1897.
APPOINTED BY THE GOVERNOR.
W. P. Beall, M. D Grreensboro.
Terra Expires 1897.
W. J. LuMSDEN, M. D Elizabeth City.
Term Expires 1897.
F. P. Venable, Ph. D., F. C. S Chapel Hill.
Term Bxpii'es 1897.
John C. Chase, Sanitary Engineer Wilmington.
Terra Bxpii'es 1897.
Richard H. Lewis, M. D., Secretary Raleigh.
Term Expires 1897.
1
STANDING COMMITTEES.
Epidemics—Drs. Lewis and Whitehead.
Water Supply and Drainage—Dr. Thomas and Mr. Chase.
Hygienics of Public Schools—Drs. Whitehead and Lumsden.
Climatology—Dr. S. W. Battle.
Adulteration of Food and Medicines—Prof. F. P. Venable.
Sanitary Condition of State Institutions—Drs. Harrell
and Beall.
Vital Statistics—Drs. Lewis, Thomas and Harrell.
LIST OF COUNTY SUPERINTEXDENTS OF HEALTH IN
THE STATE OF NORTH CAROLINA, DECEMBER 31, 1896.
Alamance—Dr. R. A. Freeman, Burlington.
Alexander—Dr. T. F. Stevenson, Taylorsville.
Alleghany—Dr. Robert Thompson, Sparta.
Anson—Dr. E. S. Ashe, Wadesboro.
Ashe—Dr. L. C. Gentry, Jefferson.
Beaufort—Dr. Joshua Tayloe, Washington.
Bertie—Dr. H. V. Dunstan, AVindsor.
Bladen—Dr. Newton Robinson, Elizabethtown.
Brunswick—Dr. D. I. Watson, Soutbport.
Buncombe—Dr. E. C. Starnes, Asheville.
Burke—Dr. J. L. Laxton, Morganton.
Cabarrus—Dr. Robert S. Young, Concord.
Caldwell—Dr. A. A. Kent, Lenoir.
Camden—
Carteret—Dr. George N. Ennet, Beaufort.
Caswell—Dr. W. O- Spencer, Yanceyville.
Catawba—Dr. D. McD. Yount, Newton.
Chatham—Dr. J. Baxter Matthews, Pittsboro.
Cherokee—Dr.-J. F. Abernathy, Muri^hy.
Chowan—Dr. R. H. AVinborne, Roekyhock.
Clay—Dr. W. E. Sandei-son, Hayesville.
Cleveland—Dr. O. P. Gardner, Shelby.
Columbus—Dr. I. Jackson, Whiteville.
Crayen—Dr. J. W. Duguid, Newbern.
Cumberland—Dr. J. Vance McGougan, Fayetteville.
Currituck—
Dare—Dr. W. B. Fearing, Manteo.
Davidson—Dr. John Thames, Lexington.
Davie—Dr. James McGuire, Mocksville.
Duplin— Dr. J. C. Grady, Magnolia.
Durham—Dr. John M. Manning, Durham.
Ed&ecombe—Dr. L. L. Staton, Tarboro.
Forsyth—Dr. E. F. Strickland, Bethania.
Franklin—Dr. E. S. Foster, Louisburg.
Gaston—Dr. J. H. Jenkins, Dallas.
Gates—
Graham— •
Granville—Dr. T. L. Booth, Oxford.
Greene—Dr. Jos. E. Grimsley, Snow Hill.
Guilford—Dr. W. J. Richardson, Greensboro.
LIST OF SUPERINTENDENTS OF HEALTH.
Halifax—Dr. I. E. Grreen, Weldon.
Harnett—
Haywood—Dr. J. Ho^yell Way, Waynesville.
Henderson—
Hertford—Dr. John W. Tayloe, Union.
Hyde-
Iredell—Dr. W. J. Hill, Statesville.
Jackson—Dr. W. F. Tompkins, Webster.
Johnston—Dr. R. J. Noble, Selma.
Jones-
Lenoir—Dr. James W. Parrott, Kinston,
Lincoln—Dr. Thomas F. Costner, Lincolnton.
Macon—Dr. S. H. Lyle, Franklin.
Madison—Dr. James K. Hardwieke, Marshall.
Martin—Dr. W. H. Harrell, Williamston.
McDowell—Dr. George I. White, Marion.
Mecklenburg—Dr. H. M. Wilder, Charlotte.
Mitchell—Dr. C. E. Smith, Bakersville.
MoNTGrOMERY—Dr. W. A. Simmons, Troy.
Moore—Dr. Gilbert McLeod, Carthage.
Nash—Dr. J. J. Mann, Nashville.
New Hanoa'ER—Dr. J. C. Shepard, Wilmington.
Northampton—Dr. H. W. Lewis, Jackson.
Onslow—Dr. E. L. Cox, Jacksonville.
Orange—Dr. D. C. Parris, Hillsboro.
Pamlico—
Pasquotank—Dr. J. E. Wood, Elizabeth City.
Pender—Dr. George F. Lucas, Currie.
Perquimans—Dr. C. C. Winslow, Winfall.
Person—Dr. J. A. Wise, Roxboro.
Pitt—Dr. Frank W. Brown, Greenville.
Polk—Dr. C. J. KenAvorthy, Tryon.
Randolph—Dr. T. T. Ferree, Ashboro.
Richmond—Dr. W. H. Steele, Rockingham.
Robeson—Dr. T. A. Norment, Jr., Lumberton.
Rockingham—Dr. D. W. Courts, Reidsville.
Rowan—Dr. John Whitehead, Salisbury.
Rutherford—Dr. E. B. Harris, Rutherfordton.
Sampson—Dr. John A. Stevens, Clinton.
Stanly—Dr. D. P. Whitley, Millingport.
Stokes—Dr. W. L. McCanless, Danbury.
Surry—Dr. 'John R. Woltz, Dobson.
Swain—Dr. A. M. Bennett, Bryson City.
Transylvania—Dr. M. M. King, Brevard.
Tyrrell—Dr. B. W. Cohn, Columbia.
LIST OF SUPERINTENDENTS OF HEALTH.
Union—Dr. J. E. Ashcraft, Monroe.
Vance—Dr. J. H. Tucker, Henderson.
Wake—Dr. P. E. Hines, Raleigh.
Warren—Dr. Geo. A. Foote, Warrenton.
Washington-
Watauga—Dr. W. B. Councill, Boone.
Wayne—Dr. W. J. Jones, Jr., Goldsboro.
Wilkes—Dr. J. M. Turner, Wilkesboro.
Wilson—Dr. Nathan Anderson, Wilson.
Yadkin—Dr. T. R. Harding, Yadkinville.
Yancey—Dr. J. L. Ray, Burnsville.
LETTEE OF TRANSMISSION.
North Carolina Board of Health,
Office of the Secretary,
Ealeigh, N. C, January 7, 1897.
«
His Excellency Elias Oarr,
Governor of North Carolina^
Sir:—In accordance with Section 3, Chapter 214, Laws
of 1893, I have the honor to present this the Sixth Bien-nial
Report of the North Carolina Board of Health.
With great respect,
Your obedient servant,
RICHARD H. LEAVIS, M. D.,
Secretary and Treasurer.
SIXTH BIENNIAL REPORT
OF THE
NORTH CAROLINA BOARD OF HEALTH.
1896-1896.
During the past biennial period tlie State has been
greatly blessed in its escape from any serious or wide-spread
epidemic of disease. As an illustration we cite
the fact that not a single case of small-pox has occurred
within our borders, notwithstanding its prevalence in
many widely scattered localities in tlie United States.
We deserve no credit for this, however, for unfortunately
the people as a whole are most discouragingly indiflferent
to the importance of vaccination. As a consequence
thousands—hundreds of thousands, we may say—of our
people are unprotected and present a rich harvest for that
particular messenger of death, should it come to us, as it
may at any hour, atid in the course of time surely will.
But the Board of Health is powerless, beyond offering
advice, which in the absence of imminent danger goes
unheeded, for the reason tiiat under the law it has only
advisory powers and cannot compel obedience to the
plainest and most urgent sanitary rules. Owing to this
want of power our work has been for the last two years,
as in the past, chiefly educational. Our efforts have been
directed to instructing the people in the j)rinciples of
hygiene and impressing upon them the importance and
value, looked at from the money point of view as well as
from tliat of life and comfort, of a proper observance of
8 NORTH CAROLINA BOARD OF HEALTH.
the rules of health. This work has been accomplished
through the instrumentality of letters from the Secretary
in particular cases, the Monthly Bulletin^ health confer-ences,
and the distribution of health pamphlets. Two
" health conferences with the people " have been held since
our last report, one at Washington on the 16th of Xovem-t
»er, 1895, and the other at Charlotte on October 15, 1896.
These w^ere well attended, especially the former, at which
people were turned away for want of room. Much inter-est
in the proceedings, which consisted of the reading of
papers, by members of the Board and others invited by the
Board, of a popular character on practical subjects, the
discussion of the matters thus brought forward and ques
tions by individuals in the audience. Nearly 30,000 each
of three health pamphlets and 20,000 of another have been
distributed. By these means sanitary seed have been sown
broadcast from Cherokee to Currituck, and although many
fell by the wayside or on stony ground or among thorns,
some have fallen on good ground and brought forth fruit.
While we cannot claim to have yet secured a good "stand"
the field grows greener with each succeeding year and
the prospect of a harvest more encouraging.
A detailed statement of the work of the Board since our
last report will be found in the following pages.
MEETINGS OF THE BOARD.
CALLED MEETING AT EALEIGH,
January 29, 1895.
In the absence of a quornni an informal consultation
by the three members present, viz. : Drs. Thomas. Harrell
and Yenable, besides the Secretary, was held with the last
named in regard to sanitary legislation by the General
Assembly then in session.
MINUTES OF THE ANNUAL MEETING AT
GOLDS BOPtO, IN 1895.
GoLDSBORO, N. C., May 15, 1895.
The Board met in annual session. Piesent, President
Thomas, Drs. Harrell and Yenable, and the Secretary.
The minutes of the last meeting were read and approved.
The term of the President having expired, Dr. George
Gillett Thomas was unanimously reelected.
Upon invitation Drs. Albert Anderson and W. T. Pate,
who had completed the course in practical bacteriology at
the laboratory of the United States Marine Hospital serv-ice
under Passed Assistant Surgeon, J. J. Kinyoun—this
privilege having been extended to them by the Board
upon the offer of the Marine Hospital service—appeared
before the meeting. The question as to the best arrange-ment
to be made betw^een them and the Board in regard
to bacteriological examinations was mutually discussed.
It was finally decided that they should provide all their
10 NORTH CAKOLINA BOARD OF HEALTH.
apparatus and that the Board would pay them for work
done. They were requested to submit a schedule of
charges.
Upon motion the secretary was instructed in view of the
absence of a quorum to submit a copy of the proceedings
of this meeting to the absent members by letter for their
approval or disapproval.
On motion Washington was selected as the place for
holding the next healtii conference in October, the exact
date to be set by the President.
On motion two hundred dollars per annum were appro-priated
for clerical help to the Secretary.
On motion the action of the Secretary in having 10,000
copies of " Instructions for Quarantine and Disinfection '^
printed for distribution with the other health pamphlets
was endorsed.
On motion the Secretary was instructed to have printed
in pamphlet fnrm the paper on " Typhoid Fever" read by
Dr.. A. R. Wilson, of Greensboro, before the Salisbury
• Health Conference, together with the secnon of the law
bearing on that disease, for general distribution.
On motion the Secretary was authorized to have printed
as many copies of the several health pamphlets as in hi&
judgment could be distributed to advantage.
The Treasurer, on motion, was given permission to
send his report by mail to the auditing committee, com-posed
of Drs. Tenable and Harrell.
On motion the Board adjourned.
RICHARD H. LEWIS,
Secretary.
In compliance with the instructions above given the
following letter was sent to all tiie members of the Board
who were not present at the meeting, and their replies
unanimously approving the action taken by those present
are on file in the Secretary's office.
sixth biennial report. 11
North Carolina Board of Health,
Raleigh, October 21, 1895.
Dear Doctor :—At the Goldsboro meeting, on May 15th, it was
moved that in view of the fact of a want of a quorum, the Sec-retary
be instructed to submit by letter a copy of these proceed-ings
to the absent members of the Board for tlieir approval or dis-approval,
in order to make effective any action that may be
taken.
Drs. Thomas, Harrell, Venable and the Secretary were present.
Anderson and Pate appeared before the Board by invitation, and
the best arrangement as to bacteriological work by them for the
Board was discussed. It was decided to pay them for the work
done, and they were requested to submit to the Board a schedule
of charges. Dr. Gr. Gr. Thomas was unanimously re-elected Presi-dent.
Washington was selected as the place for the next Health
Conference, the date in October to be set by the President. On
motion it was ordered that $200 per annum be appropriated for
clerical help to the Secretary. The action of the Secretary in hav-ing
printed 10,000 copies of instructions for quarantine and disin-fection
for distribution with the other health pamphlets was
approved. He was instructed to have printed for general distri-bution
Dr. A. R. Wilson's paper on " The Importance of Disin-fecting
the Bowel Discharges in Typhoid Fever." He was also
authorized to have printed as many additional copies of all the
pamphlets as he might think advisable. The Treasurer was
given permission to send his report by mail to the auditing com-mittee,
composed of Drs. Harrell and Venable.
Please let me have your report on the above by return mail and
oblige.
Yours very truU%
RICH'D H. LEWIS,
Secretary.
MmUTES OF THE MEETING AT AVASHINGTON,
NOVEMBER 6, 1895.
Hotel Nicholson,
Washington, N. C, November 6, 1S95.
After the adjournineiit of tlie Health Conference, which
was a pronounced success, the Board met in private ses-sion.
Present, Drs. Harrell and Venable, Mr. Chase and
the Secretary. In the absence of the President Dr. Har-
12 NORTH CAROLINA BOARD OF HEALTH.
rell was called to the chair. There being no quorum no
formal business was transacted, but a general discussion
of future work for the Board was had. Dr. Harrell handed
in the Treasurer's report, approved by himself and Dr.
Yenable, the auditing committee.
KICH'D H. LEWIS,
Secretary.
MINUTES OF THE ANNUAL MEETING AT
WINSTON IN 1896.
Phcenix Hotel, Winston, N. C, May 12, 1896.
The annual meeting was called to order by President
Thomas. Present, Drs. Thomas, Battle, Harrell, Lums-den,
Venable and Lewis—and Dr. P. L. Murphy of the
State Hos])ital by invitation.
On motion the reading of the minutes of the last meet-ing
was postponed.
The question of the best place for the next health con-ference
coming up, Charlotte was selected—the time to be
set by the Secretary after conference with the President
of the Board and the local physicians.
On motion it was decided to have made during the year,
by committees to be appointed by the President, an
inspection of all the public institutions and convict camps.
The advisability of quaratitining measles was discussed.
It was decided that it would be wisest not to attem.pt to
enforce it.
The subject of further distribution of health pamphlets
was considered but no action taken.
The care of the incurable insane of the State was like-wise
discussed at considerable length.
On motion the Board adjourned to meet again to-morrow.
RICHARD H. LEWIS,
Secretary.
SIXTH BIENNIAL REPORT. 13
Phcenix Hotel, Winston, N. C, May 13, 1896.
Pursuant to adjournment last evening the Board met,
with Dr. Harrell presiding, in the temporary absence of
the President. The President coming in resumed the
chair. Present, Drs. Thomas, Harrell, Whitehead, Yen-able,
Lumsden and Lewis.
On motion another edition of the present health pam-phlets,
together with Dr. Yenable's paper on "Impurities
in Drinking Water," Mr. Chase's on "Sanitary Drainage
and Disposal of Household Wastes " and the paper on
" The Care of the Eyes and Ears," written some years ago
at the request of the Board by the present Secretary and
stereotyped at that time by the then Secretary, Dr. Wood,
of 20,000 or more copies in the discretion of the Secretary,
was ordered printed, bound in one volume and distributed.
On motion it was ordered that a chemical and bacterio-logical
examination be made of the public municipal water
supplies of the State. Dr. Yenable kindly offered to
make for the Board one chemical analysis of each supply.
The question of having an examination made of the water
supplies of the public institutions was dii^cussed, and left
for decision to the visiting committees.
On motion Dr. P. L. Murphy, Superintendent of the
State Hospital at Morganton, was requested to prepare
and read before the proposed health conference at Char-lotte
a popular article on the importance and best method
of caring for the incurable insane of the State.
The Secretary and another member of the Board, to be
appointed by the President, were selected as delegates to
the annual meetine; of the American Public Health Asso-ciation
at Buffalo in September.
Dr. Yenable, who was appointed a committee to audit
the accounts of the Treasurer, reported them correct.
On motion the Board adjourned to meet at Charlotte.
RICHAPvD H. LEWIS,
Secretary^
14 NORTH CAROLINA BOARD OF HEALTH.
MINUTES OF THE MEETING AT CHARLOTTE
IN OCTOBER, 1896.
Charlotte, N. C, October 15, 1896.
In one of the intervals between the meetings of the
Health Conference a business meeting of the Board was
held in the Buford House. All the members, except
Dr. Harrell, who was detained at home by sickness in his
family, were present. Passed Assistant Surgeon J. J.
Kinyoun, of the Marine Hospital Service, and Dr. Mnrphy,
of the State Hospital at Morganton, were also present by
invitation.
The Secretary presented the reports of Drs. Anderson
and Pate, the bacteriologists of the Board, of their exam-inations
of the water supplies of Asheville, Salisbury,
Concord, Greensboro, Salem, "Winston, Durham, Raleigh,
Henderson, Goldsboro, Wilmington and Newbern, and
stated that he had been unable to obtain, up to that time,
through the usual channels, proper samples from Charlotte
and Fayetteville. He called attention to the fact that five
of these supplies were reported as infected with intestinal
bacilli and three as being suspicious.
On motion, the Secretary was instructed to have made
immediately another bacteriological and chemical examina-tion
of all the infected and suspicious waters ; and lie was
further ordered in fliose cases where the water was shown
to be still bad, to notify the Superintendent of Health, the
Mayor and the Manager of the Water Works of the fact,
and call upon them in the interest of the public health to
remedy the trouble, and if he did not receive satisfactory
assurances within 30 days that this had been done, to have
the analyses published in the local papers for the informa-tion
of the people using said waters.
An offer to the Board by Dr. R. H. Whitehead, the
head of the Medical Department of the State University,
to make free of charge the serum diagnosis test for typhoid
SIXTH BIENNIAL REPOKT. 15
fever for physicians desiring it, was presentee'. On
motion, Dr. Whiteliead's kind offer was accepted with
thanks, and the Secretary authorized to distribute the
necessary information among the profession of the State,
to make it effective.
A letter from Dr. Munroe, asking that the Engineer of
the Board be sent to Davidson College to advise as to the
best disposal of the sewage from the new medical building-there
was read. On motion, Mr. Chase was requested to
visit Davidson and give all sanitary advice that might be
indicated. He was also requested to make a sanitary
inspection of the Orphan Asylum at Oxford.
Resolutions of thanks to Dr. Kinyoun for his interesting
address on " Bacteria " to the Conference, and to Dr.
Murphy for his excellent paper on the " Care of the
Insane," were adopted. On motion, the Secretary was
instructed to have 5,000 copies of the latter printed and
distributed for the information of the people on this
important subject.
On motion, the Board adjourned.
RICH'D H. LEWIS,
Secretary.
16 NORTH CAROLINA BOARD OF HEALTH.
PROCEEDINGS
OF THE
CONJOINT SESSIONS OF THE STATE BOARD OF HEALTH
WITH THE
State Medical Society in 1895 and 1896.
The Conjoint Session at Goldsboro, Mat 15, 1895.
The Conjoint Session was called to order at 12 o'clock
by the President, Dr. Geo. G. Thomas, of Wilmington.
The President stated that the expiration of the terms of
Dr. W. H. Harrell, of Williamston, and Dr. John White-head,
of Salisbury, made it necessary to go into an election
for members to fill their places.
Dr. W. H. Harrell, of Williamston, and Dr. John AVhite-head,
of Salisbury, were nnanimonsly elected to succeed
themselves in office.
Dr. R. H. Lewis, the Secretary, read his report.
ANNUAL REPORT OF THE SECRETARY OF THE
NORTH CAROLINA BOARD OF HEALTH
FOR THE YEAR 1891-'95.
The law of the State requires the Secretary of the Board
of Health to make biennially to the General Assembly,
through the Governor, a report of their work. He is also
required by the Board to make to its conjoint session with
the State Medical Society an annual report. As the
General Assembly and the Society do not meet- at the
SIXTH BIENNIAL REPORT. 17
same time the periods embraced in these reports are not
synchronous, and the result is that the biennial report
overlaps and includes a large part of the report which is
made to you in odd years. In consequence of this fact the
report of our work for the period embraced between our
last meeting and January 1, 1895, has already been pub-lished
in the Fifth Biennial Report to the General As-sembly,
copies of which you will find on the desk of the
Secretary of the Society.
Since the first of the current calendar year c-oniiiara-tively
little new work has been undertaken. With a
Legislature dominated by a new element in our State
politics whose attitude towards the public institutions in
general, and the Board of Health in particular, was un-known,
it was thought to be wisest to pursue a Fabian
policy, lest our being too rfiuch in evidence might bring
disaster upon the labor of years. It is extremely trra-tify-ing
to be able to say that our fears proved to be entirely
groundless. This mattei having alread}- been set forth in
the Report of the Committee on Legislation no farther
refereni-e to it is required.
The most successful and in every way encouraging
meeting tlie Board has ever held was that '' with the
people " at the Salisbury Health Conference in September
last. A full account of the proceedings wi'l be found in
the appendix to the Biennial Report. Among the papers
read on that occasion were, one entitled "Suggestions on
the Prevention of Tuberculosis as We Know it To-day,"
by Dr. S. West ray Battle, of the Boaid, and another on
" Drinking AYater in its Relation to Malarial Diseases,"
by the Secretary. These papers were ordered by the
Board to be published in pamphlet form for general dis-tribution,
and I had 10,000 copies of each printed from
the type already set up f^r the Biennial Report. Feeling
that the people needed instruction in regard to the inij)ort-
2
18 NORTH CAROLINA BOARD OF HEALTH.
ance of quarantine and disinfection in contagions diseases
as well as in the matters of tuberculosis and malaria, and
that we should take advantage of the opportunity to
widely spread such information at a trifling cost, I took
the responsibility of having the same number of " Instruc-tions
for Quarantine and Disinfection" reprinted. I
began the distribution by sending a set of the pamphlets
to all newspapers in the State with the following letter :
Dear Sir :—I send you by this mail, under separate cover,
copies of two pamphlets published by the Board for general dis-tribution
entitled "Suggestions on the Prevention of Tubercu-losis
as we Know it To day,'" and " Drinking Water in its Relation
to Malarial Diseases." If they meet with your approval I would
thank you to notice them in your paper, and especially to notify
your readers that I would be verj' glad to send them just as many
copies as they will read or agree to distribute among their neigh-bors.
The widest distribution possible of these publications is
desired. Anything you can do to help the Board in their work of
preventing disease will be highly appreciated by them and by.
Tours very truly,
R. H. LEWIS, M. D., Secretary.
Xot having af•ce^s to most of the papers I cannot tell to
what exteut the request was complied with, but a number
CMiirHining the desired notice have been sent me, and no
don lit many others were equally kiiid.
In order to extend as much as possible the distribution
I prepared and had printed 10,000 copies of a circular
letter to our i;)hysicians.
With a view to an accurate distribution I returned to
the Clerks of Court of all the counties in the State for re-visal
and correction in the lists of registered physicians
kindly sent me by them in response to my request^ two
years ago. All have been sent back except thirteen. To
every registered physician in the other 83 counties I have
mailed a copy of each of the three pamphlets and the cir-cular
letter, and will mail them to those in the other thir-teen
as soon as the lists, for which I have written again,
SIXTH BIENNIAL REPORT. 19
come in. To all County Superintendents I have sent
them in quantity, and also to those who have written for
them with a promise to distribute them. In order to in-sure
the thorough dissemination of the information on all
the subjects treated of in the three pamphlets I have en-closed
in each large package a copy of this circular letter :
Dear Sir :—I send you a number of copies of " Prevention of
Tuberculosis as we Know it To-day," " Drinking Water in its Rela-lation
to Malarial Diseases," "Instructions for Quarantine and
Disinfection," and circular letter for distribution. As the Board
desires to disseminate the information contained in each as widely
as possible amone: the people I would thank you to give to each
person a complete set of all four. Although a pei'son may express
a desire for only one, give him all of them.
If you find you can distribute more let me know and I will take
much pleasure in replenishing your stock. Any efforts to help us
in this work would be greatly appreciated by the Board.
Very truly yours,
RICHARD H. LEWIS, M. D , Secretary.
That the publications liave been received with much
favor is evident from the newspaper notices, which some
of you have doubtless seen, and still more from the num-ber
of applications which I have received for them in re-sponse
to the circular letter, and the invitation published
in many of the newspapers, perhaps all of them. The ex-act
number asked for so far in the applications which give
figures is 4,093, varying in quantity from 1 to " 300 or
more." In addition 22 requests of an indefinite character
have come in, such as, for example, " a few," " some," " a
great many," " as mar)y as you may please to send," " as
many as you can spare," " enough to supply the drug
stores of Fayetteville," " a sufticient quantity for a crowd
of a thousand expected at the closing exercises of a
school," etc. The ten thousand have been already nearly
exhausted and the present demand has not by any means
been supplied. I believe that 60,000 could be scattered
through the State with benefit fur the education of the
20 NORTH CAROLINA BOARD OF HEALTH.
people in these practical sanitary questions. Something
on typhoid fever should accompany the publications men-tioned
above. AVe already have it in hand in an admir-able
article on that subject read before the Salisbury
Health Conference by Dr. A. R. Wilson, the live and
energetic Superintendent of Guilford County, which you
will find in the proceedings of that meeting printed in the
appendix to the Biennial Report. With the sections of
the law especially applying to typhoid fever as 'an adden-dum
that paper would I am sure do much good. I trust
that it may be the pleasure of the Board to order it
*
printed in the same form and sent out with the others
hereafter.
If it meet with the approval of the Board it is my inten-tion
to send these pamphlets to all the State and County
officers, to the professors in all our colleges and high
schools, to every lawyer, especially to every preacher, that
he may be incited to preach in private to his flock the
gospel of physical health, to leading farmers and mer-chants
and to every one who shall ask for them. But after
all no class of our citizens can advance the cause of pre-ventive
medi(;ine as can our physicians, for the simple
reason that they aloue can speak ex cathedra. It is, how-ever,
a very discouraging fact that many are quite indif-ferent
to the claims of this branch of our calling, and I
avail myself of the opportunity aiforded by this conjoint
session to again appeal to you to lend a hand and help to
build up in the profession generally a sentiment favorable
to the active promotion of that which has in it such poten-tialities
for good to all the people. We have received
gratifying assurances from various sources that the work
done in the past year has been the most successful in the
history of the Board of Health. With the cordial support
and active co-operation of the medical men of the State
SIXTH BIENNIAL KEPORT. 21
we can confidently look forward to far o-reater results.
Without it our best directed and most earnest efforts
must prove largely barren and unprofitable.
It will be remembered that the U. S. Marine Hospital
Service, through Passed Assistant Surgeon J.J. Kinyoun
extended an invitation to our Board at the last annual
meeting, at Greensboro, to send representatives to Wash-ington
for the purpose of receiving free a six weeks course
of instruction in practical sanitary biology, in the hibora-tory
of the Service.
I am gratified to report that Dr. Albert Andert-un, of
AVilson, and Dr. W. T. Pate, of Gibson Station, applied
for the privilege, and in January last availed themselves
of it. They report a very satisfactory experience, and
are now fully equal to the bacteriological examinations
called for in practical sanitation. They desire to make
some return for the privilege enjoyed through the cour-tesy
of our Board by doing a reasonable amount of work
for us without charge. Dr. J. Howell Way, of Waynes-ville,
has recently made application to the Board for an
appointment to the Laboratory, and as soon as it may
mutually suit the convenience of himself and the Superin-tendent
of the Laboratory it will be given him.
The invitation is open to any member of the Society as
long as the offer of the Marine Hospital Service in this
matter stands. . ,
DISCUSSION.
Dr. Haigh said that in ]^is section of country there had
been a great deal of interest taken in sanitation, and espe-cially
in regard to the supplj' of water. Of late years the
malarial cases had assumed a more serious form, that of
hemorrhagic fever. The simple driven pump is not hav-ing
the full effect expected, that is, not giving freedom
from surface water. He wished all the information he
could get upon the subject. He had never seen the peo-
22 NORTH CAROLINA BOAED OF HEALTH.
•
pie take more interest in matters cominpj from the State
Board of Health. He was sure that the profession would
help the Board in every way in distributing these tracts.
Dr. Booth was glad that the Board was holding meet-ino-
s ronnd through the State, and he thought that the
Board was doing a great work.
The report of the Secretary was received.
Dr. Geo. H. AYest presented, through the Secretary, a
paper on the •' Influence of AVater on Malarial Fever." It
was read by title and referred.
The Secretary stated that Dr. West reported his experi-ence
as a physician to the convict camps on the Roanoke
river. He had found a marked diff'erence in the amount
of malaria caused from the driven pump and the open
well. The desire is to get through the impervious layer
of marl and clay ; but he had found tlie malaria very much
diminished by wells 25 or 30 feet deep, tho' not through the
marl or clay. The Secretary reported a letter he had gotten
from Dr. Whitaker, the County Superintendent of Jones
county, of Trenton. Dr. AVliitaker said in his letter that
Trenton was situated oti a ridge, with the river on one side
and a mill-pond on the otiier. The people on the ridge rarely
ever suifered from malarial troubles, but there was one
well on the slope—the people who drank from it suflered
very much from malarial diseases. The dam of the pond
broke in the spring and was^n/)t repaired until the follow-ing
fall, and the bottom of that pond lay exposed to tlie
suns of that summer on the South side of the town during
the entire season, and there was no increase whatever in
the amount of malaria in the town. Dr. AYhitaker him-self
and others fished in the little pi)ols without the slight-est
hesitation and never had any malarial fever. He said
that afterwards something got the matter with the mill
and the owner turned off the water in order to repair his
mill, and the consequence was deep indignation on the
SIXTH BIENNIAL REPORT. 23
part of the people of Ti-enton ; but, instead of an increase
in the amonnt of malaria during that August and Septem-ber,
if there was any difierence at all, there was less than
there wms before.
The President reported a series of cases from Jackson-ville,
N. C, bearing upon this qnestion. The town is
practically enclosed by New River ; it is in Onslow county.
On the point of this peninsula is situated a large saw-milling
plant. These patients (all young men), having
been warned of the dangers, had used Apollinaris and
otlier bottled spring waters. All of the water was abso-lutely
protected, but they had frequent and severe attacks
of malaria. He suggested to these youno; men tliat, in
addition to the care they exercised, they insist upon their
cook boiling everv day the water used in cooking their
food that came from a well outside 140 feet deep. It went
down through the mud layer and the layer of sand and
layer of clay. So far the experiment of bniling the water
has done very well. One of the young gentlemen has liad
occasional outbreak of malaria. There has been ro sign
of an outbreak among the others since tlie boiling began.
Dr. O. McMullan said that he had read Dr. Lewih' pam-phlet.
His experience ran back some twelve years or more
in the eastern part of the country, and it went to show
that malarial troubles were greatly diminished in 1S84
and 1885, when there were very little. Frequently tiirough
whole years only four or five cases are heard of. The peo-ple
all improved when the open wells and springs were
first substituted by driven pumps; but the chills are all
coming back again. In the year 1893 there was a decided
change, and in the spring the people all over the country
began to have chills. He thought t'^at there must be some
fallacy in the theory that the water was the cause of tlie
chills and fever.
Dr. Sikes wished to corroborate what had just been said.
24 NORTH CAROLINA BOARD OF HEALTH.
In the year 1882 nearly everybody in the hill 'country had
chills. Then they had no more chills, except a few up
and down the border of a swamp, until 1894. They did
not have any pumps nor make any change, drinking the
same water and exposed to the same causes all the time.
Chills come in his country by epidemics.
Dr. Duffy did not wish to detract anything from the
importance of a good supply of drinking water, but he did
wish to say something in favor of bad air as a possible
cause. He related the history of a set of cases that fell
under his observation last year. At a place five miles from
Xewbern, known as Fay's Mill, the pond had become dry,
and had been so for several years. A stream of water ran
through the bed. A family lived there on the verge of
that mill-pond and drank from a spring that ran from a
rock. That was the only water they used, and the most
malignant case of malarial fever that he saw during that
year was in tliat family. One patient was totally uncon-scious
from having convulsions. Fortunately, he had a
supply of Sharp & Dohme's bimuriate of quinine for hypo-dennic
injection, and he recovered. There were a number
of cases in that family. While he did not think that the
importance of good wells could l)e exaggerated, still he
thought that an eye ousht to be kept on' bad air also.
Dr. Lewis said that those who had read his pamphlet
would bear in mind that he did not commit himself
entirely to tlie water theory, but at the same time it was
written from the point of view of an advocate, and that
he had deliberately overlooked, so far as he could, any
evidence on the other side. He did it because if the peo-ple
were given any avenue of escape they would take it,
and he left out a good deal of evidence on purpose.
He was surprised to note that the word cistern had been
left entirely out of the discussion. He was a stronger
advocate of tlie cistern than of the driven well, but failing
the cistern he advocated the driven well.
SIXTH BIEXNIAL REPORT. 25
Dr. Lewis was asked if he thought the malarial germ
could go seventy-five or eiglity feet below the surface.
He said he believed it not impossible for the germ to go
down the side of the pipe.
Dr. Pate said that there are other things about the well
beside malarial poison. Tiie old bucket and the old svs^eep
system are very frequently the cause of the infection of
the water by typhoid fever and other germs. It was
almost impossible to get a washerwoman who could not go
and wash the poison from her hands into the well by
handling the chain or pole after they had been infected by
the soiled clothes. He was sure that he had seen cases of
typhoid fever arising from that source, and he recom-mended
the bored well to ])revent that infection as well as
others.
Dr. Haigh asked about the leports of health from the
different counties. The death-rates of several small places
had been so high that they attracted his attention, and he
asked if there was any special cause.
Dr. Lewis, in answering, read the reports and explained
that tlie death-rates appearing monthly in the Bulletin
were merely temporary. Many of the returns were worth-less
on account of the town authorities not taking proper
care to render the reports accurate. In one town there
are some 3,500 negroes, and months and months will pass
without a single death of a negro reported. That is
because the regulations in regard to statistics of deaths are
not carried out. The only way to make the statistics accu-rate
is not to allow a dead body to be removed until a
death certificate has been signed by a physician or a nuig- ,
istrate. A report under l2 per thousand he considered
worthless.
The President did not consider the statistics as worth
anything, but could see no way at present to enforce the
26 NORTH CAROLINA BOARD OF HEALTH.
laws. Many valuable points could be brought out and
very simple certificate. It ought to cover not only the
age and race, but the place of birth and how long the per-son
had resided in the place of his death. It would affect
the sanitary history of a town very materially. A person
coming to a town and dying in a month of something con-tracted
before, affects the death-rate of a town and its san-itary
histoi'y very injuriously.
That brings up aiK)ther very important subject—that of
acclimatization of foreigners. In looking over the deaths
from yellow fever he had noticed that Germans died more
rapidly than any others. A great many people died of
so-called bilious fever of the ty]>e in Wood's Practice.
Dr. Guiteras, in studying the nature of the fevers of the
South, believed some of these were cases of yellow fever
unrecognized, and he says that a large portion of the proof
is based upon the fact that newly arrived emigrants died
of it.
The Conjoint Session then adjourned.
GEO. GILLETT THOMAS, M. D., PresidenL
Richard H. Lewis, M. D., Secretary.
SIXTH BIENNIAL REPORT. 27
CONJOINT SESSION AT WINSTON, MAY 63, 1896.
The Conjoint Session was called to order bj Dr. Geo.
Gillett Thomas, President of tlie Board of Health.
At the first order of business the session listened to the
following address of the President
:
The cause of preventive medicine, wliieh we represent,
is receiving everywhere the increasing support of the laity
and the law-makers; and it behooves us, therefore, to care-fully
consider all the problems tliat the session may
present to us.
Men of thought and genuine public spirit, men who are
not politicians from any selfish motive save the laudable
ambition of helping and being accounted as promoting all
measures that will bring the greatest good to the greatest
number. Men of scientific attainments, not the mere
scholar and student, but men possessed of knowledge that
they can and do turn to a practical use, all men of great
worth and close observation are flocking to the aid of the
sanitarians.
In proof of this the meeting of the American Public
Health Association is largely composed of laymen, but
they are just as much interested and in earnest as the pro-fessional
men, and the quota of the work which these lay
members furnish is just as important and impressive
as that sent in by tlie members of our medical profession.
AYe feel, therefore, that w(> ought to seriously ask ourselves
if we each and every one are doing all in our power to aid
in the work of the Board of Health of this State.
During the year just ended, your Board of Health has
been less conspicuously employed than in former years,
28 NORTH CAROLINA BOARD OF HEALTH.
but they have been none the less active. Under the
skillful guidance of their most etScient Secretary, Dr. E..
H. Lewis, the work has become more and more system-atized,
and the only flaws of importance in the laws at the
present are the want of more mandatory powers, and more
money to effect the execution of the orders of the Board.
The health meeting at Washington, one of the mission-ary
sanitary conventions, of the purpose and scope of
which you were apprised last year, was a marked success,
and is bearing legitimate fruit right now. These meetings
will be repeated just as often as possible. It must be
remembered that the personnel of the Board is composed
of active practitioners and laymen who are always
intensely engaged. Due consideration for the life work
of these men must be had always in projecting iind carry-ing
into effect one of these meetings. There is no doubt
that the examination of drinking water here and there all
over the State, examinations made to clear up the history
of outbreaks f;f disease, has opened the eyes of the people
to the necessity of more care in the provision of the water
they nse. Coupled with tliis is the work of Dr. Lewis in
the studj' of the connection of malaria with drinking
water. It is quite impossible to measure the extent
of good that is the outcome of his earnest labors in this
field. I know of a certainty that it lias impressed people
who have never heard of or read his excellent monograph,
bnt have come into possession of the facts which he so
admirably set forth. Those of you who saw the exhaustive
report of Dr. Pate on the sample of water sent to him from
"Wilmington, and the clear connection that his examination
established between the drinking water used at a gather-ing
of young people and certain cases of typhoid fever
occurring among them, will realize of how much importance
this new departure of the Board of Health is worth.
I believe that it is a fact that typhoid fever, that deadly
SIXTH BIENNIAL REPORT. 29
scourge, is a preventable disease, and that gradually it
will be so environed by preventive measures that it will
be staniped out. This hope and belief is no doubt to be
realized in a.future more or less distant, but it is a well
founded hope never the less. Tuberculosis, the great
rival of enteric fever, will also be controlled, and materi-ally
lessened, or be made to vanish, as the laws for its
control are gradually evolved from the study and efforts
of the sanitarians. These are not vain hopes or Utopian
dreams. Cholera has been controlled, yellow fever has
been stopped at the border, small pox is isolated and
checked by vaccination, and these are the work of health
authorities.
There is a subject worthy of your serious consideration
both as citizens and physicians. There are, as many, I
might say all, of you know, a large class of insane people
who are classed as incurable, and on account of their
mental troubles they are in some of the counties gather-ing
in the alms house—in others confined in jails, and in
all of the counties a large number of them go about at
large, constituting a menace to the communities in which
they live, as well as often imposing a burden upon the
household that is realh^ unable to care for them. It is
safe to say that no insane person, no matter what the char-acter
of the mental abberation may be, is other than a
dangerous person and liable to do damage at an unlooked
for moment ; or in the case of females become the prey of
brutal men. This subject was presented to you in Raleigh
at the joint session of 1893 by Dr. Hodges, and it is oppor-tune
now to revive it. He did not suggest any plan for
the relief of these dements that was seized upon. It seems
now that something ought to be done,* and to elicit dis-cussion
and an exchange of opinion, I propose that you
consider the propriety of asking the Legislature to pro-vide
district asylums for these people. The general asy-
30 NORTH CAROLINA BOARD OF HEALTH.
liims are not large enough to accommodate them, nor is
there any provision for them in the financial budget of the
State. As you meet them in your rides through the city
streets or along the county roads, or see them in homes,
where they are unwelcome inmates, you often wonder why
some sort of law is not enacted, providing for the isolation
and care of tlie poor helpless creatures.
At present, as I have said, they are cared for in some places
better than others by the County Commissioners and are
pensioners upon the tax-payers. It seems that these dements
could be gathered together j*n groups, as for instance all
of the counties in a congressional district sending their
pauper insane, who cannot be admitted to the general hos-pitals
at Raleigh, Morganton or Goldsboro, to a hospital
to be established at some central point in the district and
maintained b}' the counties comprising this district. If
too many counties were in any of these districts other
divisions of fewer counties might be made. Provisions for
the control and care of these hospitals and the inmates
could be made by a general board of control under the
guidance of the Commissioners of Charities, assessments
to be laid on each county according to the number of
inmates sent. This plan would increase the salaried offic-ers
of the State and unfortunately would necessitate more
political appointments.
This plan or some othe ' should l)e adopted tV-r the care
of these unfortunates, and this would naturally lead up to
the establishment of schools for feeble minded children,
enabling them to be taught to be of some service to them-selves
and to the State. This neglect of these stricken
people has been too long allowed, and their wrongs and
needs cry aloud for redress. We hope to have the matter
seriously considered and to present it again until some
action is taken.
There is another subject that needs legislation.
SIXTH BIENNIAL REPORT. 31
The health resorts of tlie State are growing in number
and importance. Those that have risen to the rank and
dignity of towns are under some sort of medical and muni-cipal
control. But the large majority of these places pro-vide
only for summer visitors, and are under no regu-larly
instituted supervision in matters of hygiene. The
consequence is that sickness of more or less serious nature
is the first thing that arouses these people, the hotel and
boarding house keepers, to the necessity for any care for
their sanitary surroundings. It would seem, therefore,
that any of these resorts where large numbers of our peo-ple
congregete during the hot months of the year, if there
is no responsible health officer to direct matters, that the
Board of Health of the State should have the power to
interfere in behalf of both the householders and visitors
and establish rules and regulations for their safety, with
the power also to infiict penalties for violations or neglect.
Let me thank you for your interest in the work
which, as your delegated authority, we have been doing
and bespeak a continued and increasing interest in the
labors of the Board of Health.
Dr. O'Hagan said :—I am sorry to say that in man}'
instances the position of Health Officer in many counties
is eagerly sought for and competed for by medical men
who have not the honor of the profession at heart nor who
duly appreciate its dignity. It has degenerated down into
a little miserable petty office which has not been properly
remunerated. The suggestion made by Dr. Thomas as to
the sanitary control of mineral springs and health resorts
is, I think, very timely. I beg to suggest to his consider-ation
and that of the Board that there should be some lea;-
islation giving them power to exercise jurisdiction over
large boarding schools throughout the State which, I think,
in at least one instance that I know of, totally disregarded
all sanitary laws. There has been a lamentable neglect
32 NORTH CAROLINA BOARD OF HEALTH.
of control of these institutions as to proper feedina:, sanita-tion
of buildinii and the surroundings, proper lighting, ven-tilation,
etc. In some I know the pupils have not been
properly fed. I know one instance where the water which
was used for ice was taken from a pond which was largely
contaminated by poultry and other living animals, and
large portions of filth, etc., had been piled up during the
winter season for the use of the pupils the following sea-son.
Sanitation was grossly neglected. Then the light-ing
of the study rooms was insufficient and unliealthful,
and the result vcas a great prevalence of eye diseases.
Whether the present sanitary legislation of the State
empowers the Board of Health to pay regular visits I am
not aware, but if it does not give power to control these
matters to some extent, it certainly ought. As to the care
of the insane, I appeal to the members of the Society to
interfere in some way or othei- for the relief of these unfor-tunates.
But even supposing that there was any efficient
legislation, I think that there should be an entire change
in the methods of providing for the care and sustenance of
the unfortunates. We have been spending large sums of
money in completing buildings, and if this money were
properly distributed it would enable us to take care of
twice that number in a more efficient manner. I make
these suggestions, that there should be some means by
which sanitary visits shonld be paid to public schools, that
it should be made the duty of the superintendents of edu"
cation (who are generally unfit for the position) that they
should insist that the light, ventilation and drinking water
should be the best that can be had. In many instances I
know the drinking water is not good. I know that the
light and ventilation is totally insufficient and prejudicial
to study and health. I think that instead of having great
central hospitals like those of Goldsboro and the Raleigh
Insane Asylum, which would involve an enormous expen-
SIXTH BIENNIAL REPORT. 33
ditiire of money, they should be done away with and a
building of more humble degree should be erected in each
Congressional district, and the expenses would come imme-diately
out of the pockets of the people of that Congres-sional
district, and the one who has charge of this building
would be held strictly accountable for the condition of it,
and would be directly under the eye of the friends and
relatives of the unfortunate inmates.
Dr. Murphy agreed with the President that no insane
person conld be considered as safe—they are liable to
become dangerous at any moment. He explained the con.
dition of the buildings at Morganton, and while the cost
per bed at the present time was above $200 probably, tliis
included the original cost of the grounds and executive
buildings. He had mapped out plans whereby additional
quarters could be supplied, on the colonization plan, at
considerably less than $100 per bed. He thought it would
be more economical and more beneficial to provide room at
the existing asylums than provide many separate institu-tions.
The Secretary, Dr. R. H. Lewis, read his annual report.
34 NORTH CAROLINA BOARD OF HEALTH.
EEPORT OF THE SECRETARY OF THE NORTH
CAROLINA BOARD OF HEALTH FOR THE
YEARS 1895-'96.
The past year has been, I ani happy to say, an unevent-ful
one in sanitary matters. No epidemics of disease
liave occurred, and small-pox, which has prevailed, more
or less, over the whole conntry, has passed us by entirely.
Fortunate, indeed, is it that we have escaped such a visi-tation,
for immense numbers of our people remain unvac-cinated,
and your Secretary frankly admits that he cannot
devise any method of materially reducino; the niimber.
The only thing that seems to have any effect whatever is
the actual or supposed presence of the disease in a com-munity,
and whenever a scare is heard of the Superintend-ent
of Health is urged to utilize it to the fullest extent
and vaccinate as many as possible.
But while our work has been chiefly routine, I believe
it has been the most effective in the history of the Board.
It has consisted, in large part, in continuing the distribu-tion
(already inaugurated at our last meeting) throughout
the state, in various ways, of the health pamphlets with
which you are familiar.
In compliance with your instructions, I added to the
pamphlets published up to that time the excellent paper
read before the Salisbury Health Conference by Dr. A. R.
Wilson, of Greensboro, on " The Importance of Disinfect-ing
the Bowel Discharges in Typhoid Fever," supplement-ing
it with the section of the law bearing on that disease,
and a short account of the famous Plymouth epidemic.
Acting upon the authority given me at our last annual
meeting, I had printed 20,000 copies each of these articles :
" Prevention of Tuberculosis," "Drinking Water in Its
Relation to Malarial Diseases," and " Instructions for
SIXTH BIENNIAL KKPORT. 35
Quarantine and Disinfection," and liav'e distributed nearly
all of them. They have been sent to all the newspapers
in the State, all the physicians, all the lawyers, nearly all
the ministers, white and black, public officials, State,
county and municipal, the more prominent teachers, and
to numerous individuals whose names were sent to me in
response to the circular letter enclosed in every package,
askin<>; the reader to send me the name and address of
ever}' one he thought would read them. As the Board
has very wisely, in my liumble opinion, in our present
stage of sanitary development, determined to direct its
efforts mainly to interesting and edu ating the people in
the principles of preventive medicine and impressing
upon them the advantages to be derived from a strict
observance of the laws of health ; and, as large numbers
of our public school teachers, farmers and merchants have
not yet seen them, I would respectfully suggest the advis-ability
of printing another edition of at least 20,000 more.
It would be well to sup[)lement the publications named
above with the excellent papers on "Impurities in Drink-ing
water'" and "Sanitary Drainage and Disposal of
Household Wastes," read at the Washington Health Con-ference
by Dr. F. P. Venable and Mr. J. C. Chase, respec-tively,
and perhaps also with the article on " The Care of
the Eyes and Ears," as it was stereotyped by my lamented
predecessor and the cost of paper and press-work would
not be great. Since it is desirable that instruction should
be given in all the subjects treated, and as our plan has
been to send a complete set to everj^ one, even if he asked
for only one, it would be less expensive and mor» satisfac-tory
in eveiy way to have them all bound together. We
can doubtless have the literature intended for the teachers
of the public schools distributed by the Superintendent of
Public Instruction without cost to the Board, which would
mean a very considerable saving in postage.
36 NORTH CAROLINA BOARD OF HEALTH.
In this contiection yon will be interested to know that
in Se}3teniber last I received a letter from the Rev. Phil-lips
Yerner, of South Carolina, a worthy grandson of the
late Charles Phillips, D. D., for so many years the distin-guished
Professor of Mathematics in our University, who
expected to go shortly as a missionary of the Presbyterian
Church to the Kassai river country, in the Congo Free
State, asking fur the publications of our Board on the sub-ject
of malaria, and promising to send us the result of his
observations and experience in that pestilential valley. If
it should turn out that the saving of the life of even one
of the noble men who have taken their lives in their
hands for God and humanity is accomplished, we might
Avell feel that our labors have not been in vain.
Whether it is attributable directly or indirectly to our
stirring of the waters, it is nunc the less a gratifying fact
that a Social Science Club established at Trinity College
has taken up the sul)ject of sanitation. The request of its
Secretary for any literature we might have was, it goes
without saying, gladly honored to the fullest extent of onr
ability, and our satisfaction was still further deepened by
reading in the papers an excellent article on the general
subject by Professor Dowd, the President of the Club. It
is to be hoped that all our institutions will, as years go by,
while not relaxing their efforts for the development of the
'"'"mens sana^'' lay more and more stress on the ''corpore
sajio,^' not only by a judicious encouragement of athletics,
but by giving instruction as to the means of preventing
those ills to which all flesh is heir and before which the
strongest^athlete, when once in their clutches, is liable to
be " downed " forever.
HEALTH CONFERENCE AT WASHINGTON.
On November 6th the Second Health Conference with
the people was held at Washington, Like the first at Salis-
SIXTH BIENNIAL REi'OKT. 37
bun', in September, 1894, it was quite a success. A num-ber
of" papers were read and discussed. One of tliese, on'^Pre-ventive
Medicine," by Dr. J. C. Rodman, was published
in the North Carolina Medical Journal, and the others,
with the exception of Mr. Chase's, on " Sanitary Drainage
and Disposal of Household AVastes," have already appeared
in the Bulletin. This last will he printed i]i our next
issue. The profession of the town and vicinity and the
citizens evinced much interest, as was shown by the fact
that the hall was tilled literally to overflowing, many
being turned away for want of room—an occurrence most
gratifying and unexpected, for, as we were constrained to
say in a notice of the meeting in the Bulletin for Novem-ber
: "We never expected to live to see tiie day when
people in North Carolina would be turned away from a
health meeting for want of room." Those present still
further showed the sincerity of their interest by the ques-tions
thev asked. AVhile the influence of these meetings
does not visibly extend beyond the immediate community
where they are held, they do undoubtedly, from assur-ances
to that eflfect we have received, make a decided
impression within those limits. And if we can biing our
larger towns to a realization of the importance of sound
sanitarv laws well administered, we shall surelv accom-plish
great good. In order to extend more rapidly this
form of work, it might, perhaps, be well to supplement
the conference of the whole Board with the people of the
larger cities and towns by having small committees from
the Board hold what might be properly called Health
Institutes in the smaller places.
national control of sanitary matters.
The following correspondence on this subject betM'een
His Excellency Governor Carr and your Secretary
explains itself. It should, however, be stated tliat an
V
38 NORTH CAROLINA HOARD OF HEALTH.
expression of opinion from tlie Board, in its corporate
capacity being impossible, the views given are merely
those of the .writer:
State of North Carolina, Executive Department,
Raleigh, January 11, 1896.
Dr. Richard H. Lewis, Secretary North Carolina Board of Health,
Raleigh, N. C.
Dear Sir :—I am instructed by the Governor to enclose you a
letter from Joseph F. Edwards, asking for brief expressions on
the advisability of a National Code of Sanitary Laws, etc. The
Governor would be glad if you will give him your views in regard
to this matter.
I have the honor to be, yours very truly,
S. F. Telfair,
Private Secretary.
North Carolina State Board of Health,
Office of the Secretary, 217 N. Wilmington St.,
Raleigh, N. C, January 14, 189G.
His Excellenci/ Governor Carr.
Dear Sir :—In replying to your communication enclosing a
circular letter from Mr. J. F. Edwards, editor of The Annals of
Hygiene, and requesting an expression of my views upon the
question, "Should we have a comprehensive State or National
Code of Sanitary Laws, designed to promote the health of the
people, the observance of which should be made compulsory and
their infringement, made punishable, or should we be satisfied
with efforts to educate the people up to the importance of a vol-untary
observance of sanitary laws V Should we compel or coax
obedience to the laws of health propounded therein?" I beg to
say :
The State can have no higher duty than the protection of the
life and health of its citizens, and it should, therefore, exert all its
powers to promote that end, so that in my opinion it should employ
both compulsion and education—the latter always and every-where,
and the former whenever practicable. In a city with a well-organized
and equipped health bureau, with a strong police force
to back it up, sanitary laws might be fairly enforced in the face
of an adverse public opinion (until the next election), Init in a
sparsely settled rural community, like our State, for the most part,
any law unsupported by public opinion would be a dead letter.
At the same time the very existence of such laws upon the statute
books would have an educational influence, and attempts to
enforce them would stir up the people, excite interest in. and dis-
SIXTH BIENNIAL REPORT. 39
cussion of, the subject, and open their minds to the importance of,
and need for, such laws. The few that we now have relating to
contagious diseases, the contamination of water supplies, etc.,'
have undoubtedlj^ advanced the cause of the public health,
although I have never known of a single person being punished
for the violation of one of them. This is especially true of our
cities and towns.
Our own State Board of Health, having only advisory powers,
has devoted itself to the education of the people by the distribu-tion
of literature of a practical character, and by holding "health
conferences with the people," and I am gratified at the assurance
from various quarters that we have made a distinct and favorable
impression upon the public mind.
I am opposed, personally and oflficially, to the interference of
the General Government in our local affairs, sanitary or other-wise,
except upon request, in times of emergency beyond our
power to meet.
With great respect, I ajn, very truly, yours,
' Richard H. Lewis, M. D.,
Secretary.
VITAL STATISTICS.
Realizing that vital statistics, unless accurate, are prac-tically
worthless, and being convinced from the figures
that the reports sent in from some of onr towns were given
incomplete, I made an eftbrt to secure greater accuracy by
sending the following circular letter to all the health
officers making reports :
North Carolina State Board of Health,
Ob^FiCE OF THE SECRETARY, 217 X. Wilmington St..
Raleigh, N. C, liovember 1, 1801.
Dear Sir :—Vital statistics, to be of any value, must be accurate.
The only vital statistics obtainable in our State are the mortuary
reports from the cities and towns. Some of these reports bear
upon their face evidence of inaccuracy—incompleteness. It is not
just to the towns making full reports and giving the real death-rate
that they should be placed in the same category with those
which do not. I therefore propose, beginning with the December
reports, to print in bold-faced type those reports which are vouched
for by the officials making them, and to call attention to that fact
in a foot-note, so that any one examining the tables may know
which are reliable. If you wish your reports to go into the higher
class do not fail every month to have their accuracy vouched for
by the proper official over his own signature.
40 NORTH CAROLINA BOARD OF nEALTH,
I would respectfully call your attention to thp fact that reliable
mortuary statistics are unattainable in the cities and larger towns
otherwise than by a rigid enforcement of an ordinance forbidding,
under penalty, the burial or removal of a dead body without an
official permit based upon a duly executed death certificate. I
enclose model ordinance and sample blanks, that they may be of
assistance.
Your cordial co-operation in this matter is earnestly desired.
Very truly yours,
Richard H. Lewis, M. D.,
Secretary.
The certificate printed at the bottom of every mortuary
blank that the health officer was required to sign to secure
tlie placing of his town in the list of those regarded as
making reliable reports, was this : " I hereby certify that
this leport gives the whole number of deaths occurring
within the corporate limits during the above month."
Notwithstanding this there are still three or four towns
wiiich, for one reason or another, have not complied with
this requirement, and have in consequence to be enrolled
in the second class. It is to be hoped that this will be
remedied. Owing to the fact that we are so laro;elv a
rural population our only opportunity to obtain vital
statistics is afforded by our towns, and in tliese days of
scientific accuracy mere assertions as to the healthfulness
of our State do not satisfy the intelligent inquirer.
COUNTY BOARDS OF HEALTH.
It is with much regret that I am compelled to report a
discouraging amount of indifierence in a good many
localities on this subject on the part of the members
of the profession. In a number of counties at the reg-ular
biennial meeting, on the first Monday of September
last, a legal quorum could not be obtained. And this,
too, in spite of a circular letter sent with the notice of the
meeting (required of me by the law) to every registered
physician in the State, calling attention to the decision of
SIXTH BIENNIAL REPORT. 41
the Attorney General to the effect that no action on the
pait of the boards wonhl he valid unless a majority of all
those eligible to membersliip participated, and urging upon
the readers the importance of selecting their own sii])er-intendent
of health, and not allowing the privilege to
lapse into the hands of the county commissioners. While
in many instances the commissioners elected superintend-ents,
in at least one instance that has come to my knowl-edge
tliey took advantage of the opportunity to give the
place to the lowest bidder, thereby reducing the salary, —
that had been $250, to '^50, and in others they M'ent
still further, and refused to elect any superintendent at
all. As a consequence of this the number of counties
having superintendents of health l\as been reduced from -
90 to S6. At one time there were 91 counties having
superintendents, but in Graham, before the last election,
the superintendent left the county and no successor has
ever been elected. Camden, Currituck, Hyde, Pamlico
and Washington have never oro;anized countv boards, not-withstanding
repeated efforts on my part to accomplish it.
The chairman of the board of commissioners of Pamlico,
who was the only one replying, stated that they could not
find a physician who would accept the office. Why he
did not say, but proljably because of the sniall pay offered
in that small county. Since September 1, 1895, for differ-ent
causes the county superintendent of health has been
discontinued in Chatham, Gates, Henderson and Jones.
This retrogression, as a fact, is discouraging, but the men-tal
or moral attitude of the authorities towards sanitation
and the proper care of the poor and of the prisoners is yet
more so. There is only one v/ay to renjedy this condition
of things, and that is by educating public opinion. As
mentioned above, the Board is trying to do this itself, as
far as the means at its disposal will allow. But no infiu-enee
can -1)6 brought to bear comparable to that of the
42 ifOBTH CAROLINA BOARD OF HEALTH.
family physician. If the members of the profession Avonld
cordially co-operate with the Board and show to their
patients an active interest in hygiene and impress upon
them the valne and importance of its laws, great things
conld be accomplished. Can we not obtain that help ?
Are not our medical men, admittedly among the best edu-cated
in the country, sufhciently enlightened and humane
to lend their interested aid to so grand a cause as the
wholesale saving of life? We can but believe that the
cause of this indifference on the part of so many—not all,
by any means—is simply tlioughtlessness—they have never
considered the (juestion seriously. We sincerely hope for
better things from them. While these discouragements
and others press upon us there is no question that the
public mind has been appreciably awakened, and that the
people of the State, as a w^hole, are much more interested
in, and alive to the importance of, preventive medicine
than they were twelve months ago. AVe have not been
standing still.
On motion the conjoint session adjourned.
GEORGE GILLETT THOMAS, M. D.,
President.
Richard H. Lewis, M. D.,
Secretary.
SIXTH BIENNIAL REPORT. 43
REPORT ON THE SANITARY CONDITION OF
THE STATE AND OTHER INSTITUTIONS.
Owing to the exhaustion of the appropriation made by
the General Assembly for the work of the Board, the
usual inspection of the convict camps could not be made.
All the State institutions proper were, however, visited
and inspected, as appears from the particular reports
below :
NORTH CAROLIN^A INSAiSE ASYLUM, INSTITUTION FOR
THE DEAF, DUMB AND THE BLIND, PENITENTIARY,
STATE CAPITOL.
Dr. George G. Thomas, President of the State Board of Healtli.
Sir :—The Committee of the Board of Health appointed to make
a sanitary ins^pection of the North Carolina Insane Asylum, the
Institution for the Deaf, Dumb and the Blind, the Penitentiary
and the State Capitol, begs leave to submit the following report :
NORTH CAROLINA INSANE ASYLUM.
Y'our Committee was received with every courtesy by Dr.
Faison in the absence of the Superintendent, and was shown
through every ward in the Asylum. The wards upon the male
side Avere too much crowded, but the additional wing in process of
erection will relieve the present wards of this undue strain. The
sanitary condition of these wards was otherwise good. The
cleanliness, neatness and good ventilation were worthy of note.
The water closets flushed Avell and seeuipd to be well trapped.
Very little odor was noticeable from them . The same was true of
the female wards. The arrangements for feeding the patients
were neat and wholesome.
The Asylum is excellently located for drainage purposes, and
there is no reason why this should not be perfect. The water
supply is, however, a point which should receive the careful
attention of the authorities of the Asylum. The boring of a deep
well which is now in progress may remedy all defects along this
line. When completed the water of this well should be carefully
examined and its quality determined. The stables, dairy and pig-styes
were also visited and found in good condition, and so not at
all a source of danger to the Asylum.
INSTITUTION FOR THE BLIND—WHITE.
Everj" opportunity for any inspection of the buildings was
afforded vour Committee through the kind attention of the Prin
44 NORTH CAROLINA BOARD OF HEALTH.
cipal, Mr. Ray. The ventilating arrangements for one of the large
sleeping rooms for the boys seemed imperfect. It would be diffi-cult
to admit the needed fresh air. where so many were sleeping,
without serious drafts, in the present arrangements. The water
closet provided for the boys is poorly fitted up, dark and not well
ventilated. The boarding up of some of the sinks and washstands
is also objectionable. The absence of the proper storage rooms
for trunks, &c., is a serious disadvantage with which the Superin-tendent
has to labor, necessitating an overcrowding of the sleep-ing
quarters.
The sewerage system is connected with that of the city. The
water supply is also in part the city water. Fur food purposes the
main reliance seems to be placed upon the well immediately in the
rear of the building. ]^fo examination has been made of this water
in the past two years, and the suggestion was made by your Com-mittee
that it be carefully examined and periodically watched in
the future, as its location makes it liable to contamination at any
time. There is a large cistern already constructed. This might
be thoroughly cleansed and fresh water caught from the roofs and
used in preference to the present supply.
INSTITUTION FOR THE DEAF, DUMB AND THE BLIND—COLORED.
The interior arrangements of this building, sleeping rooms, hos-pital
wards, bath-rooms, closets, &c., seemed to be verj^ good.
Storage room is, however, needed, and imijroved furnishings for
the outside closets for the boys. The large well, from which much
of the water for drinking purposes is taken, is, from its depth, loca"
tion and proximity to the drains, not above suspicion. It has been
recently cleaned out, but its purity has not been tested in some
years and should be carefully looked into.
THE PENITENTIARY.
Your committee went over the penitentiary buildings under the
.guidance of Capt. Fleming. Comparatively few convicts were
under his charge at the time of our visit. The buildings are in
good order and the health of the convicts seems to be well cared
for. We think it would be wise to substitute a complete system
of water closets, with good sewerage connections, for the present
combination of water and earth-closets, and also to continue the
exit pipe from the drain at least as far as the bed of the creek and
not let it empty just outside the wall, as at present. The water
used is partially derived from wells. These should be carefully
watched and examined. It would seem to be safer to ,use the
water from the large and excellent spring just below the walls.
SIXTH BIENNIAL KEPOKT. 45
THE STATE CAPITOL.
The plumbing and sanitary arrangements, as far as could be
seen, seemed to be good. The building is connected with the city-water
and sewerage system. The water from the well in the Cap-itol
Square is used by some in preference to the city water.
Respectfully,
S. Westray Battle.
F. P. Venable.
STATE U]S^IVERSITY, COLLEGE OF AGrRICULTURE AND
THE MECHANIC ARTS.
November 6, 1896.
Dr. George G. Thomas, President North Carolina Board of Health.
Dear Sir :—Following we give a report of our visits to the pub-lic
institutions assigned us by the Board.
THE STATE UNIVERSITY.
AVe find the general sanitary condition satisfactory. A good
number of fixtures of an improved type have been provided, and
the sewerage is discharged into a small branch at a proper distance
from the buildings.
The water supply, which comes from a large well on the campus,
appears to be falling ofl' in quantity, and at the time of our visit
the supply was so limited that no use could be made of the baths,
and the urinals had very irregular flushing. For the latter fixt-ures
a plentiful supply of .water is very essential, and we consider
the question of increasing the present supply a vital one.
The present shortness of supply is undoubtedly caused, in a
large measure, by the use of several hundred gallons per day by
the elefetric light engines, but be that as it may, the necessity of
more water is so evident as to require no argument. An abundant
supply can be had from either of two neighboring creeks at a dis-tance
of a mile or more from the present center of use.
It is probable that the present supply can be inci-eased sufH-ciently
to answer the purpose for awhile longer by sinking one or
two more wells at a distance from the present one, but we are of
the opinion that the natui-ally increasing use will eventually be-come
so large that the supply could not be maintained by wells
having such a comparatively small area tributarj^ to them as the
ones under consideration.
Should a supply be obtained from one of tlie creeks before
mentioned we should consider it advisable to provide a plant that
would be able to supply other consumers as Avell, which would
materially aid in meeting the operating expenses.
We ai"e pleased to note the installation of a well arranged elec-tric
lighting ijlant, which lights the grounds and buildings very
efficiently. Also the opening of a "'Commons'' boarding hall in
46 NORTH CAROLINA BOARD OF HEALTH.
the gynasium building. We desire to testify to the particular
cleanliness and attractiveness of everything connected with this
establishment, and from personal experience can heartily com-mend
the dietary both in quality and quantity.
THE COLLEGE OF AGRICULTURE AND MECHANIC ARTS.
The conditions at this institution are practically the same as
when visited by a representative of the Board (Mr. Chase) some
two years ago and set forth in his report.
The increased attendance and additional buildings erected
emphasize the desirability and necessity of an improvement in the
sanitary arrangements, certainly so far as convenience and com-fort
are concerned. In these days baths and water closets have
come to be regarded as necessary adjuncts of our civilization, espe-cially
when there is any large aggregation of human beings, and
we consider that in this specific instance no reasonable expense
should be permitted to debar their installation.
We are aware that the question of sewage disposal has been
regarded as a serious if not insuperable obstacle in the way of
making a general use of sanitary fixtures. We would by no means
advise the discharge of the crude sewage into the small branch
that passes through the College grounds, even if there were no
prospect of objections being raised by abuttors on the stream
further down.
AVe fully believe that the limited amount of sewage to be pro-vided
for can be readily disposed of by surface irrigation on the
lowest portion of the College tract, near the railroad, and that such
disposal will be no more objectionable or detrimental to health
than the existing privies and stables.
We do not feel ourselves called upon to go into details regard-ing
the manner of carrying out such a work, that being the prov-ince
of an engineer, and the nature and gravity of the work would
necessarily require the employment of one. Suffice it to say that
an object lesson can be had at the State Hospital for the Insane at
Columbia, S. C, the sewage of that institution being disposed
of in the way above mentioned.
If no change is made in the existing methods we believe that a
better type of privy could be provided, and they could certainly
be kept in better condition.
The supply of water has lately been increased by means of sev-eral
driven wells, which yield a fair supply of satisfactory quality.
While we are not prepared to say that there is any danger of their
becoming contaminated by any pollution of the surface of the
ground immediately above them, we do not consider that it is
quite in accordance with sanitary teachings to make use of the
SIXTH BIENNIAL KEPORT. 47
ground about these Avells for a cow yard. There is a certain sen-tinient
about such matters that it is Avell to bear in mind, and it
should not be forgotten that the youth who are educated at this
institution are likely to be no small factor in assisting to raise the
standard of refinement and civilization throughovit the State.
Respectfully submitted,
Richard H. Lewis,
John C. Chase.
THE STATE NORMAL AND INDUSTRIAL SCHOOL.
Dr. George G. Thomas, President State Board of Health, Wil-mington,
N. C.
Dear Sir :—In accordance with your instructions of May 14th,
we have visited the State Normal School at Greensboro and con-ferred
with President Melver in regard to the best method of
sewage disposal for that institution.
While excreta and general household wastes are occasionally
disposed of by cremation in such institutions, we do not deem
that method of disposal worthy of consideration in the present
instance.
Water carriage is universally admitted to be the best method of
removing household wastes and the method of ultimate disposal
will depend upon local conditions.
In this particular instance the construction of a pipe sewer some
two thousand feet in length would discharge the sewage into a
small branch where the danger of its becoming a nuisance would
be improbable, at least until the quantity is largely in excess of
what it is likely to be in the near future.
As there seems to have been an idea prevailing that this method
of disposal might contaminate the city water supply it is proper
to say that such fears are unfounded, as the branch into which
the sewage will be discharged joins the stream on which the city
water works are located below the point where the supply is
taken.
We recommend that the branches from the various buildings
should be six inches in diameter and the main sewer eight inches ;
that the minimum grade of the former should be one foot fall in
fifty feet, and of the latter one in eighty. Also that an automatic
flush-tank be put in, to be operated by the waste water from the
laundry, and that provision be made to turn a certain amount of
roof water into tlie drains running from the other buildings.
The best quality of salt-glazed sewer pipe should be used. It
should be laid true to line and grade, and all changes in direction,
48 NOKTir CAROLINA BOARD OF HEALTH.
either lateral or vertical, should be made at angles eased off by
slight curves, which are made acces^sible by luanholes. By avoid-ing
the use of long curves and having the sewer straight between
the manholes any obstruction can be easily located and removed
Avith the least possible difficulty. Additional manholes should be
provided, so that the maximum distance between any two should
not exceed four hundred feet.
We consider that the magnitude and importance of this work
demand the services of an engineer skilled in such Avork. We
believe that definite data to prospective bidders on the projected
work will reduce the cost to an extent that will fully justify the
additional outlay and at the same time the future integritj'of the
work will be assured.
The plans for the new infirmary were submitted for our inspec-tion.
The proposed building seems to be well adapted to the
purpose for which it is designed and the only suggestion we have
to offer is, that the bath tubs should be in separate rooms from
the water closets.
Respectfully submitted,
John C. Chase.
W. P. Beall, M. D.
Wilmington, May 20, 1896.
December 1, 1896.
THE STATE NORMAL AND INDUSTRIAL SCHOOL AND
THE AGRICULTURAL AND MECHANICAL COLLEGE FOR
THE COLORED RACE.
Dr. Geo. G. Thomas, President of North Carolina Board of Health.
Dear Sir :—We have visited the State Normal School and the
Agricultural and Mechanical College at Greensboro, as instructed
by the Board, and submit the following report :
At the first-named institution we find the sanitary condition
highly satisfactory. Since last visited by a representative of the
Board a sewer has been constructed which discharges the house-hold
wastes into a small branch at a point some two thousand
feet from the buildings. This sewer was laid in substantial
accordance with the advice given by the Engineer of the Board
on May 30, 1895, and the work appears to have been done in a
first-class manner. We are pleased to learn that the advice of the
Board was followed in employing an engineer to design and super-intend
the construction of the work. Two flush-tanks were put
in as recommended, but no provision was made to provide a regu-lar
and sufficient supply of water for their operation and the pres-ent
condition of the sewer shows the effect of the omission. AVe
therefore recommend that the flush-tanks he supplied from the
SIXTH BIENNIAL REPORT. 49
water works system of the institution, such supply to be so gauged
that the tanks will discharge every 24 or 36 hours. We also ad-vise
that a small covered catch basin be built at the sewer outlet,
designed to retain the solid portion of the sewage, which could be
removed and buried from time to time. At the present time this
matter is deposited along the sides of the branch and is rather
unsightly, although its distance from dwellings would preclude
the idea of its being a nuisance, for the present at least. We are
inclined to believe, however, that the time will come when it will
be found advisable to dispose of the sewage by surface irrigation
and an admirable chance can be had at a short distance from the
present outfall.
The water supply of the institution for general purposes comes
from the city water works. At the time of our visit the supply
was shut off on account of repairs to the street main so none of the
fixtures could be seen in operation, but the general appearance
and arrangement of the plumbing was satisfactory.
Since our last visit a well arranged infirmary has been built,
ane tlie only adverse criticism we have to offer is that our sugges-tion
was not followed in regard to placing the water closets and
bath tubs in separate rooms. An additional isolated water closet
can be very easily provided, hov.ever.
At the Agricultural and Mechanical College we find that the
water supply in the kitchen comes from the city watersupply, but
no other fixtures are in use. The only sanitary conveniences are
the ordinary box type of privies, which appear to be kept in good
condition.
We consider it highly advisable that this institution should be
equipped with baths and water closets, not only as a means of
comfort and also conducive to healtli, but on account of the ele-vating
and refining influences that will naturally result.
The sewage of the institution can be very easily disposed of by
surface irrigation. The general condition of the grounds and
buildings metit commendation.
By invitation of Dr. W. J. Richardson, County Superintendent
of Health, we visited the jail in Greensboro. The general condi-tion
has recently been somewhat improved by the introduction of
water closets, but tliere is no gainsaying the fact that a new jail
of modern construction is imperatively needed. The present
structure is a disgrace to the intelligent community which toler-ates
it, and the fact is so ^elf-evident to any one who may visit it
that we do not feel called upon to go into particulars.
In this connection we desire to express our conviction that there
should be some restrictions against the overcrowding of jails. In
some cases this is caused by using them as places of temporary
4
50 NORTH CAROLINA BOARD OF HEALTH.
detention of Federal prisoners awaiting trial, and the rapacity of
the jailer for the resulting- profits of boarding the prisoners appears
to be the only measure of the capacity of the jail.
Respectfully submitted,
John C. Chase.
W. P. Beall.
school for the deaf and dumb.
Board of Directors, School for the Deaf and Dumb,
Morganton, N. C.
GtENTlemen :—The undersigned, a committee appointed by the
State Board of Health to make a sanitary inspection of your insti-tution,
beg leave to report as follows :
Desiring to see the institution in its everyday state, we purposely
did not not notify the Superintendent of the time of our proposed
visit. We are very glad to be able to state that we found it in
excellent condition. We noted one or two small leaks about the
water-closets. We also commented on the wooden block under a
bath-tub on the girls' side resting in the channel for the waste
water from the shower baths. The position of the tub should be
changed, or a support of some material impervious to water sub-stituted
for the block of wood.
In a part of the basement and in the bottom of one of the ven-tilating
shafts, we observed an accumulation of litter, which, while
not positively dangerous to health, perhaps, was offensive to the
sanitary sense.
We called the attention of your wide-awake Superintendent to
all these matters, and he informed us that our suggestions would
be promptly carried out.
We desire to make our acknowledgements to Superintendent
Goodwin for his courteous attentions and for his active assistance
in making the insj^ection.
Very respectfnlly yours,
George Gillett Thomas,
Richard H. Lewis,
Committee.
the state hospital at morganton.
To the Board of Directors of the State Hospital,
Gentlemen :—Under the instruction of the State Board of
Health the undersigned visited and inspected the Hospital at
Morganton, with special reference to its sanitary condition. It
gives us great pleasure to report to the body which we represent
and to yours the excellent state of affairs instituted and maintained
under vour direction for the well-being of the inmates. The
SIXTH BIENNIAL REPORT. 51
plumbing was everywhere of the best order, and the ciosets were
generally odorless. The onlj- exception existed in the wards
occupied by the more violent patients, and the condition in these
was only noticeable by comparison with the general cleanliness
that existed in every department.
The appointments of every kind in the Hospital and about the
property seemed to us to deserve only the most favorable com-ment,
unless we except the provisions for protecting the gang-wells
in the rear of the barn from the washing of the buildings,
which appears to us to be worthy of your attention.
We beg leave to commend the training school for nurses that
has been organized by the permission of your Board. It is a most
progressive measure and will redound to the good of the Hospital,
and in time measurably supply the want of trained persons in the
sick room, when these young persons have served their appointed
time under the Hospital management.
We trust that the effort to equip a bacteriological laboratory at
the Hospital will find favor with your Board. A small beginning
has been made, and we submit respectfully that it will, if projierly
enlarged and put under trained supervision, be of great service to
the institution and State at large, especially the Board of Health.
We owe to your Superintendent and his courteous and able
assistants many obligations for the aid they willingly rendered us
in the performance of our duty, and we esteem it a matter of con-gratulation
that your Board has so wisely chosen the executive
oflScers of the institution you control.
Very respectfully yours,
Geo. Gillett Thomas,
Rich'd H. Lewis,
Committee.
THE EASTERN HOSPITAL AT GOLDSBORO.
To the Board of Directors of the Eastern Hospital.
Gentlemen :—Under the instruction of the Board of Health of
North Carolina, I visited the instituiion Avhich is under your care.
The courteous and capable Superintendent showed me the build-ings
and the proi^erty immediately around them.
The well-directed improvements of the institution were every-where
manifest, and the sanitary condition of the premises, to
which I was directed to give especial attention, was excellent.
The property gave evidence of skillful management and unre-mitting
care. The plumbing was all in good condition and the
new wards you have erected were of the best modern pattern.
The wards were clean and the patients were comfortably provided
for and not crowded.
52 NORTH CAROLINA BOARD OF HEALTH.
The scheme of the Superintendent to add to his staff a female
physician of good standing will commend itself to your judgment.
I desire to tender my thanks to the Superintendent, Dr. Miller,
for his pleasant attention and assistance in ])roperly m^aking the
inspection. Very respectfully yours,
Geo. GriLLETT Thomas.
OXFORD orphan ASYLUM.
The water supi^ly comes from some deep-seated springs on the
grounds, at a distance of several hundred feet from the main
building and is pumped by steam to a metal tank in the attic of
the girls' building. The wat^^r is apparently of good quality and
there appears to be no probable chance of contamination, as
proper precautions have been taken to prevent pollution.
The girls' building is supplied with baths and water closets, and
the new buildings being erected for the boys will have like con-veniences.
The present boys' building is not a credit to the
institution, and it is gratifying to know that ere long it will be
abandoned for the new buildings, which are exceedingly well
adapted to the purposes for which they are designed. The
plumViing in the girls' building is of a generally satisfactory char-acter,
and the same can be said of the plans of that which is pro-jjosed
for the new buildings.
A new brick building to contain the kitchen and dining-rooms
is nearly completed. It is admirably an-anged for its prospective
uses and will be a great improvement over the present arrange-ments.
Several additional buildings and other improvements are
in contemplation, and 1 am pleased to know that comprehensive
location plans were made and lines for water and sewer pipes laid
down before any of the work was undertaken. This is so at
variance with the general custom in our State that it deserves
mention and commendation.
The sewage is discharged through a well-laid pipe into a ditch
with a never-failing stream of water several hundred feet from the
buildings. I am of the opinion that in due time this method of
disposal will have to be abandoned, but there is an excellent op-portunity
to adopt a scheme of surface irrigation, and as the
Superintendent is in accord with this view and has given the
matter some study, it can be safely left in his hands.
The surface drainage about the buildings will be excellent after
the improvements now in progress are completed, and I see no
reason why this institution should not retain its present high rank
for healthfulness, which, it is believed, is not excelled in the State,
taking everything into consideration.
John C. Chase.
SIXTH BIENNIAL REPORT. 53
INSTITUTIONS OTHER THAN STATE.
DAVIDSON COLLEGE.
Dr. George Q. Thomas, President N. C. Board of Health.
Dear Sir :—I submit the following report of the visit of inspec-tion
and advice made, by request, in accordance with the instruc-tions
of the Board, to
DAVIDSON COLLEGE,
for the purpose of advising in regard to the best method of sewage
disposal for a new building erected for the medical department.
The general configuration of the grounds and the limited amount
of sewage to be provided for indicated that it could be satisfac-torily
disposed of by discharging it into a small branch several
hundred feet from the building.
In the course of time it would perhap.s be advisable to make the
point of discharge farther down the valley, or if it should seem
best it could be used advantageously in surface irrigation near the
point first mentioned.
The sewage of the whole institution would most likely be dis-charged
in this direction when sanitary conveniences become
available.
The question of obtaining a water supply seems to be para-mount
at this time and it is not at all clear from whence it can be
derived.
It may not be out of place to reiterate the general instructions
given in regard to the construction of the proposed sewer. The
grade it would apparently have makes a six inch pipe ample for
the purpose. It should be of the best quality of salt-glazed pipe
and laid true to line and grade. Any change in direction, either
lateral or horizontal, should be made at angles connected by
slight curves. These curves should be made in manholes, and by
having the sewer perfectly straight between them any obstruction
can be easily located and removed. Intermediate manholes
should be put in whenever necessary, in order that the maximum
distance between two adjacent ones shall Lot exceed 300 to 350 feet.
They may be used seldom, if ever, but when they are needed their
absence will be found to be a serious inconvenience.
The institution is so advantageously located that it precludes
any uneasiness in regard to surface drainage.
Respectfully submitted,
JOHN C. CHASE.
54 NORTH CAROLINA BOARD OF HEALTH.
JOHNSTON COUNTY JAIL.
Selma, N. C, April 17, 1886.
Geo. G. Thomas, M. D., President North Carolina Board of Health,
Wilmington, N. C.
My Dear Sir :—The Board of County Commissioners of John-ston
county want to move their jail, and I would like for yovi to
appoint a committee to look out for the health of the prisoners
and make suggestions as to the sanitary conditions of the jail.
Please notify me and I will meet the committee. Let them meet
in Smithfield, Johnston county, any time between now and May
1st. Please let me hear from you at your earliest convenience.
Yours very truly,
R. J. ZS'OBLE,
Superintendent of Health of Johnston County.
Raleigh, April 28, 1896.
The Board of County Commissioners, Johnston County, N. C.
Gentlemen :—The undersigned, a committee from the State
Board of Health, at the request of your Superintendent of Health,
Dr. R. J. Noble, visited your county town of Smithfield on Mon-day,
27th inst., for the purpose of inspecting the present jail and
the site on the riverside to which it is proposed to remove the
same, and for giving an opinion from a sanitary point of view
upon the advisability of such removal. We beg leave to respect-fully
report as follows :
In company with Dr. Noble and Sheriff Elliugton, we carefully
inspected the jail. We aie much gratitied to be ^ble to say that
we found it in an excellent sanitary condition—sweet and clean,
in spite of the antiquated method of fecal removal by buckets
still in use, and a credit to the management of those in charge.
Such a desirable state of affairs under similar circumstances, we
fear is not common, and we cordially commend the enterprise and
humanity of your honorable Board in proposing to put in sewer-age
and thereby insure, as far as possible, a continuance of the
same cleanliness, in that one respect at least, in spite of unfavor-able
changes of administration that are almost sure to come as
time passes. But Ave think a mistake has been made in substitut-ing
mattresses on the floor for the swinging hammocks. They are
un.'anitary in more than one aspect, and we would respectfully
suggest a return to the hammock system, notwithstanding their
occasional destruction by the prisoners. The difference in cost
would be trifling and they are much prefei-able. We also think
your system of heating could be improved, and at small expense,
in the manner set forth below.
SIXTH BIENNIAL REPORT. 55
The site suggested for the new jail we exauiined carefully, and we
are satisfied that it is a much better one than that now occupied.
While nearer the river, we could find no reasonable ground for
thinking the danger from malaria any greater, certainly if a
sufficient supply of cistern water be provided for the inmates to
drink. The cost of a cistern made by utilizing a part of the walls
of the basement would be trifling. While a tin-roof would answer,
slate would be better and cost only S2 per square more than the
best tin, proving doubtless more economical in the long run. We
send you pamphlet on " Drinking Water in Its Relation to Mala-rial
Diseases,'' in which you will find i^laris and instructions for
building cisterns.
The chief advantage of the new location would be in the short
sewer pipe, with rapid fall, located not very far below the surface
of the ground. The long sewer, from the present location, with its
gradual fall, could not be satisfactorily flushed, owing to the scanty
water supply afforded by a 500 gallon tank filled by a hand-force
pump, and it would eventually become clogged. To dig up a sewer
so deeply buried as that would have to be to obtain the proper
fall, in order to find and clear away the obstruction, would be a
very expensive piece of work, and one that would almost surely
recur. The short, steep sewer could be scoured from end to end
daily at an outlay of a comparatively small aiU'iunt of water, and
should any accident happen to it in its course it could be taken up
entirelj^ and relaid, if necessary, at a very small cost.
We would respectfully deprecate the plan of merely reproducing
the old jail in the new. It seems to us that it would be unworthy
of a county that has the present standing and promising outlook
possessed by Johnston. In our opinion you would never I'egret
the erection of a more modern structure, in which is provided a
separate room for a sick prisoner (which could be utilized also when
the jail happened to be overcrowded), and quarters for the jailer
—
certainly for a guard—who would then always be within call so as
to promptly summon aid in case of sudden illness in the night, to
say nothing of the effect of such proximity upon the safety and
behavior of the prisoners. It is just such little finishing touches
as these which show the civilization of a community, and which
not only favorably impress the stranger, but elevate the commu-nity
itself.
Should a new jail be erected, we would respectfully suggest a
change in the method of heating nnd ventilating it. We would
recommend that the chimney be bnilt with two fines, having a
very thin partition between them—one for the smoke and the
other, extending to the floor with a register at the bottom, for
taking out the foul air. A jacketed stove with an inlet pipe pass-
56 NOKTH CAROLINA BOARD OF HEALTH.
ing through the wall should be provided. The fresh, pure air
from outside, haA'ing been warmed as it passed through the nar-row
space between the stove and jacket, would rise to the top and
force out through the ventilating flue the coldest and foulest air
in the room, which always lies next the floor. The air in this flue,
being more or less warmed thi-ough the thin partition by the hot
smoke, would rise and, therefore, draw, making a pull upon the
foul air in addition to the push given it by the warm, fresh air
constantly pouring in. The adoption of this method would fur-nish
ideal heating and ventilation at a merely nominal cost.
Expressing our appreciation of the courtesies shown us, we are
Very respectfully yours,
Geo. GriLLETT Thomas,
Rich'd H. Lewis,
Committee.
MUNICIPAL WATER SUPPLIES.
At the annual meeting of the Board at Winston the
subject of tlie municipal water supplies of the State was
discussed. Wliile the Board realized its inability to
accomplish much in the wa}- of assuring the purity of
such waters owing to the total lack of mandatory powers in
the law covering it and the insulHcienc}' of the appropri-ation
to justify more than the most cursory investigation, it
feels that something should be done. It was therefore
decided, as appears in the report of the proceedings of the
meeting printed al)ove, to have a single exaniination made
of each public water supply, that being as much as it could
hope to pay for. This was done for the purpose of inform-ing
tlie water companies that some one was overlooking
them, and with the inten ion, if a supply should be found
bad and the company refused after having its attention
called to the fact to make at least a reasonable effort to
remedy the trouble, to bring the pressure of public opin-ion
to bear upon it bv havino- the results of the investiija-tion,
setting forth the character of the water, published in
the local newspapers.
In compliance with the order of the Board the Secre-tary
mailed to the respective health othcers of the cities
SIXTH BIENNIAL REPOKT. 57
and towns havincr public water gnpplies, viz : Asheville,
Charlotte, Concord, Durham, Fas'etteville, Goldsboro,
Greensboro, HendersoTi, Newbern, Raleigh, Salem, Salis-bury,
Wilmington, Wilson, and Winston, the following
letter :
North Carolina Board of Health,
Raleigh, N. C, August 15, 1896.
My Dear Doctor :—The Board has ordered, for its own in-formation,
a bacteriological examination made of the public water
supplies of all our cities having them. It wishes the sample taken
by a medical health officer from a faucet from which drinking
water is drawn, and packed and shipped in exact accordance Avith
the directions on the back of the permit herewith enclosed. Ac-companying
this will be a sterilized bottle.
Please do not fail to take the sample, and pack iinmeiliately
with an abundance of ice and sawdust, as near the departure of
the train as possible so as to lose no time in transit.
As the Board proposes to bear all the expense you will not pre-pay
express charges. You can also i^end bill to me for cost of
packing. Your prompt and careful attention to this matter
would oblige, Youri< very truly,
RICH'D H. LEWIS, Secretary.
Upon the receipt of the rej)ort from the bacteriologists,
this letter was mailed to the health officers of the cities
having infected water:
North Carolina Board of Health,
Office of the Secretary,
Raleigh, N. C, October G, 1896.
Dear Doctor :—I learn from the duplicate report sent me by
Dr. (Anderson or Pate, as the case was) of the bacteriological ex-amination
recently made by him, at the request of the Board, of
the public water supply of your city, that the water is infected
with intestinal bacilli. It is, of course, unnecessary for me to call
your attention to the danger to the people of your community of
an infection of their water supply of such a character, or to the
importance of immediate action on j'our part in the premises. I
wou-ld thank you to let me know at once what steps you have
taken in the matter, and also what action those in control of your
water supply propose to take. As the Board is to meet at Char-lotte
on the 15th inst., a reply before Wednesday, the 14th, when
I must leave for the meeting, would be greatly appreciated.
Very truly yours,
RICH'D H. LEWIS, M. D., Secretary.
5S NORTH CAROLINA BOARD OF HEALTH.
To this letter only one reply, from Raleigh, was re-ceived.
At the meeting of the Board during the Health Con-ference
with the people in Charlotte on October 15th, two
months after this letter was mailed, the Secretary stated
that he had re'ieived from the bacteriologists employed by
the Board, Drs. Albert Anderson, of "Wilson, and W. T.
Pate, of Gibson Station, reports on all the supplies except
those of Charlotte and Fayetteville, from which he had
np to that time been unable to obtain satisfactory samples.
From the reports received (which see below) the waters of
Asheville, Concord, Greensboro, Henderson and Raleigh
were shown to be infected with intestinal bacilli, and those
of Goldsboro, Newborn and Winston suspicious, while the
remainder were more or less good.
As the result of this showing the Secretary, as appears
in the proceedings of the Board, " was instructed to have
made immediately another bacteriological and a chemical
examination of all the infected and suspicious waters ; and
he was further ordered in those cases where the water was
shown to be still bad to notify the Superintendent of
Health, the Mayor and the manager of the water w<M'ks
of the fact and call upon them in the interest of the public
health to remedy the trouble, and, if he did not receive
satisfactory assurances within thirty days that this had
been done, to have the anal_ysis published in the local
papers for the information of the peojde using said waters.
In obedience to these instructions the following letter
was sent to the health officers of the cities having water
infected with intestinal bacilli (except Henderson, the
report on its water not having been received, at that time)
and a special letter in each case to those whose water was
reported as being suspicious, which will be found in the
particular report on those supplies given furrher on.
SIXTH BIENNIAL REPOKT. 59
NORTH CAROLINA BOARD OF HEALTH.
Raleigh, October 28, 1896.
Dear Doctor :—At a meeting of the Board iu Charlotte on the
15th histant I was instructed to have made a second bacterio-logical
as well as a chemical analysis of those water supplies that
were reported by the bacteriologists of the Board to be infected
with intestinal bacilli or suspicious. As the water of your town
comes within that category I send you herewith permits for both
analyses and a sterilized bottle for the sample intended for the
bacteriologist. Be sure not to get the bottles mixed. You will
kindly draw the samples from a faucet from which drinking water
is taken, i7i strict accordance ivith the directions printed on the
back of each permit, otherwise the analysis would be vitiated and
worthless, and ship at once by express at our expense. The ster-ilized
bottle for the bacteriologist should be packed in plenty of
ice and sawdust to prevent the increase in the number of bacteria
which would surely occur unless the water is kept cold until it
reaches him.
Your prompt and careful attention would oblige.
Yours very truly,
RICHARD H. LEWIS, M. D.
Secretary.
Ill response to this letter, while all of the eight cities
and towns having infected or suspicious water sent
samples for the second bacteriological examination, only
Goldsboro and Henderson complied with the request to
send samples also for chemical analysis.
The question of public water supplies for most of our
cities and towns in North Carolina is not an easy one.
With some exceptions they must in the nature of things
get their water from small, short streams, which are
fed from cultivated and more or less thickly popu-lated
water-sheds. This renders them peculiarly
liable to dangerous infection, and extra care and super-vision
of them is demanded in the interest of the pub-lic
health. It is so serious a matter that it should not be
left to the water companies themselves, most of which are
private corporations whose principal stockholders are
often non-residents, chiefly interested in dividends. But
60 NORTH CAROLINA BOARD OF HEALTH.
even where the works are owned by the city itself the
manaojement cannot be counted on as the best always,
owing to the influence of political considerations. Legis-lation
giving the State Board of Health, a disinterested
body whose only concern is the protection of the health of
the people, control of all public water supplies with man-datory
powers is urgently called for. What could be
accomplished by the Board in this respect, if clad with
sufficient authority, can be imagined from the results given
below by its work in this direction, imperfect as it is from
lack of money and of power. The people have a right to
demand that their lawmakers should provide the means
for assuring them pure water.
In reading the reports below the correspondence given
above should be born in mind.
ASHEVILLE.
REPORT OF BACTERIOLOGICAL EXAMINATION'.
Wilson, N. C, September 28, 1896.
Dr. E. C. Starnes,
Superintendent of Health, Asheville, If. C.
Dear Dr :—A quantitative bacteriological examination of the
sample of water sent me by you from the public water supply in
your city shows 5,000 bacteria colonies to the cubic centimetre.
Any water containing over 400 colonies to the cubic centimetre
should be regarded with suspicion. The sample sent by you
showed up an abnormally large number of bacteria, which was
partly due lo the ice melting some time before sample arrived.
In culture media containing glucose, intestinal bacteria produce
fermentation with liberation of gases that collect at the top of a
fermentation tube. In my tube containing glucose bouillon there
was considerable evolution of gases, into which I liad put three
drops of your sample of water. There is an acid formed in process
of fermentation by these bacteria. In the medium of lactose-litmus-
agar—a blue medium—a culture of your water showed red
colonies from the effect of the acid produced by intestinal bacteria.
Litmus milk was converted into a pink color and plain milk was
coagulated—additional proofs of the presence of intestinal bacilli.
SIXTH BIENNIAL REPORT. 61
Judging your city water from this sample, I consider it bad and
iinfit for drinking- purposes.
Respectfully submitted,
Duplicate. ALBERT ANDERSON.
Wilson, N. C, November 30, 1892.
Dr. E. C. Starnes,
Stcperintendent of Health, Asheville, JV. C.
Dear Doctor :—I submit the following report of the bacterio-logical
analysis of the last sample of water sent me from the public
water sujDpIy of your city. There were 450 colonies of bacteria to
the cubic centimetre—more than there should be for good water,
but I find only those of a benign form in this sample.
Respectfully submitted,
Duplicate. ALBERT ANDERSON.
CHARLOTTE.
report of bacteriological examination.
Gibson Station, N. C, November 3, 1896.
Charlotte Water.
Dr. Lewis :—I collected sample of water from faucet at the
Buford Hotel October 16th, 4:40 a. m., and placed it in culture media
the same morning at 11:30. The color of sample is a yellowish
brown ; muddy ; deposit covered bottom of bottle after settling ; no
odor. The sample contains 7,500 bacteria to the cubic centimetre
of water. I have isolated several motile bacilli from this water,
among them proteus, but none of them show all of the cultural
characters of the common colon bacillus. I think it fair to say
that this water is filthy and is not safe for drinking purposes.
Yours truly,
W. T. PATE.
Raleigh, November 10, 1896.
Superintendent Water Works, Charlotte, N. C.
Dear Sir :—Dr. Pate, the Bacteriologist of the Board for Meck-lenburg
county, at the request of the Board, took a sample of
your water from a faucet in the Buford House for examination.
He reports the water to contain 7,500 bacteria to the cubic centi-metre,
and that he had isolated several motile bacilli, among them
proteus, but while none of them showed all the cultural characters
of the common colon bacillus, he concludes by saying : "I think it
fair to say that this water is filthy, and that it is not safe for drink-ing
purposes." It is unnecessary for me to say that this condition
62 NORTH CAROLINA BOARD OF HEALTH.
of affairs should be remedied at once. The Board does not wish to
do anything to harm any legitimate business, and I therefore call
your attention to the matter and give you the opportunity to
apply the remedy before I call the attention of the public authori-ties
of the city to it, as I must do under instructions from the
Board unless it is promptly done. I would suggest that you have
another sample drawn from a drinking water faucet (preferably
one in the Buford) and packed strictly in accordance with the
directions on the back of the blank which I enclose, properly cer-tified
to, and another examination made by Dr. Pate, or some
other reputable bacteriologist, immediately, and send me a copy
of his report. I would thank you to let me know at once what
you propose to do.
Yours truly,
RICHARD H. LEWIS,
Secretary.
Charlotte, N. C, November 12, 1896.
Dr. R. H. Leiois, Raleigh, N. C.
My Dear Sir :—Hutchison handed me your communication this
morning. I was surprised at the result of Dr. Pate's analysis, as I
had only a few days since received from Prof. Leeds the result of an
analysis made by him. I quote from him: ''Your bacteriologi-cal
analysis is eminently satisfactory, the water containing no
bacteria.'' AVill you kindly let me know whether or not Dr. Pate
took the water himself or who furnished it to him. Wilder, health
officer here, sent him specimen according to your instruction
some month or six weeks ago, but has heard nothing from him.
You know our filter plant has only been in operation about six
weeks, and it may be that Pate's specimen was taken from a pipe
little used and that contained a lot of the unfiltered water that had
stagnated in it. I can explain it on no other hypothesis. In any
event I shall send, or rather have sent by health officer, another
specimen to Prof. Leeds, and if you will let me know Dr. Pate's
address I will also send him specimen. Shall I write to him for
bottle, or will you give me directions for sterilizing bottle? The
specimen sent Dr. Leeds was taken from faucet on main pipe line,
but I apprehend it makes no difference where the specimen is taken
from as soon as the pipes are cleaned out, and 1 shall have the
specimen taken from main tap at the Buford Hotel. As soon as I
get returns will forward them to you. If there are any other
suggestions you would make, will hold myself obliged if you will
do so.
Understand, I shall have nothing to do with taking these speci-mens,
but will have that done in all due form. I am anxious to
SIXTH BIENNIAL REPORT. 63
have these examinations as soon as possible, as I had thought
after the analysis above alluded to that we were above criticism.
Yours truly,
R. J. BREVARD.
Raleigh, November 13, 1896.
Dr. R. J. Brevard., President Charlotte Water Co.,
Charlotte, N. C.
My Dear Doctor :—Yours of 12th instant to hand. I note with
pleasure your intention to promptly make a thorough investiga-tion
into the character of your water supply, and think it would
be well to have examinations made by both Drs. Leeds and Pat*>
—
as you propose. The address of the latter is Gibson Station, and
you shovild write to him for a sterilized bottle. The reason that
nothing has been heard from him by Dr. Wilder in regard to the
samples sent him is that neither was taken according to instruc-tions.
After waiting a month, or longer, he sent a sample from a
well, although he was requested to send a sample drawn from a
faucet of the public ivater supply, and later he sent a sample in
his own bottle (properly sterilized, doubtless, Ijut we can't take
any chances) drawn immediately from the filter—again not what
we asked for. To be sure of having it right the Board requested
Dr. Pate to take the sample himself. This he did " from faucet
at the Buford Hotel October 10, 4:40 A. M., and placed it in culture
media the same morning at 11:30"—to use his own words. When
I saw his report of 7,500 bacteria to the cubic centimetre the
explanation you suggest—that the filtered water had not gotten
into that main—occurred to me.
I cannot understand Pi'of. Leeds' statement that the water he
examined contained "no bacteria'"—he must have meant no
pathogenic bacteria. « * *
In fairness to your water I think it would be well to suggest to
the health officer the importance of packing the samj^le in an
abundance of lee and saw-dust in order to prevent the growth of
the bacteria until it can reach Dr. Pate. Dr. Pate authorized me
to say to the managers of water companies that he would make
quantitative analysis for them for $10. I enclose blank which gives
explicit directions which must be carried out to the letter, or the
analysis will be invalidated. Please let me have copy of all the
analyses you have made, and oblige,
Yours very truly,
RICHARD H. LEWIS, Secretary.
6-t NORTH CAROLINA BOARD OF HEALTH.
Charlotte, November 19, 1896.
Dr. li. H. Leiois.
m
T enclose Dr. Leed's analysis. * * * *
I wrote Dr. Pate a few days since asking him to send me two
bottles, as I wish to have specimens examined from the filter and
also from the tap at the Buford, so that I can tell whether the
trouble, should it still exist, is in the pipes. Of course I under-stand
these are separate analyses.
Now as to examinations : I found when we took charge of
the plant two, which I can't lay my hand upon, made from, I think,
Johns-Hopkins, certainly some Baltimore chemist, Avhich were
entirely satisfactory. These Avere chemical examinations. Since
that time Professor Leeds and Dr. Herbert Battle have examined
it for us. Satisfactory, except about two months ago Dr. Battle
found the free ammonia ran too high. This I knew was due to
the cause I mentioned to you, i. e. that owing to excessive drouth
and waste of water, the reservoirs were nearly empty, and when
we did have a heavy rain we had to fill up with the rain-water
which ran over the fields and meadows—was about as milddy as
possible. Since then we have gotten on a large supply, and of
course that cannot occur again, and if it becomes necessary while
it is costly I will abandon present supply and use that from Bear
Creek.
Will write you as soon as I have anything further to communi-cate.
I feel that I am giving you a good deal of trouble and cer-tainly
appreciate your kindness.
Yours truly,
R. J. BREVARD.
I did not mention that samples have been sent by health officer.
dr. leed's report.
Stevens' Institute of Technology,
HOBOKEN, N. J., November 17, 1896.
Sample of filtered water fr( m Charlotte, N. C.
The sample exhibited no bacteria after three days' culture with
gelatine peptone solution, and may be regarded as practically free
from bacteria. Very respectfully,
ALBERT R. LEEDS,
Professor of Chemistry, Stevens' Institute.
SIXTH BIENNIAL REPORT. 65
(Jharlottk, N. C, November ;^(J, 1890.
T)r. E. H. Lewis.
My Dear Sir:—I enclose you bacteriological examination made
by Professor Wm. Royal Stokes, of the Johns Hopkins Hospital,
who is also bacteriologist for the city of Baltimore, and, I believe,
of the State of Maryland. You will observe that it is addressed to
Professor Penniman, of the firm (if I may call it so) of Penniman &
Boone, chemists. They are the State chemists, and I understand
are men of very high standing. I requested them to examine it
^chemically and submit same to the best bacteriologist for exatiii-nation.
1 may mention that they made the chemical examina-tion.
Don't believe you lay mue'. stress upon chemical examina-tions,
so will not copy it, but they made this comment : " This
water shows no sign of contamination upon chemical or bacterio-logical
examination. It is admirably suited for manufacturing
and domestic purposes." Yours truly,
R. J. BREVARD.
I shall get Pate to re-examine as soon as be sends the bottle, which
he says he will do as soon as he gets a new instrument.
DR. STOKES' REPORT.
Health Department,
City Hall Annex,
Gay Street between Lexington and Saratoga Sts.,
Baltimore, Md.
Prof. Penniman.
Dear Sir :—The sample you sent me was clear, showing no
sediment upon standing twenty-four hours and no odor.
Microscopic sediment : No animaleulae, plants, algae. Germs :
jjrotocoecus spiralis.
These luinute vegetable organisms are present in pure water,
and tlie absence of animaleulae suggests this condition also.
Colonies per cubic centimeter, 146.
This is very low as compared to many of our municipal water
supplies—Philadelphia often showing 1;"),000.
Fifty centimeters of water was examined by makers of growth
in bouillon, plating, and then inoculation of fermentation tubes of
glucose, lactose and saccharose, 1 per cent, bouillon.
No gas production took place after twenty-four hours, showing
that the colon bacillus, bacillus coli communis, the normal inhab-itant
of the intestine, was not pi-esent in this amount of water.
The examination shows that the sample of water sent is pure
5
56 XOKTH CAROLINA BOARD OF HEALTH.
bacteriologically ; in fact, remarkably so. It is not customary to
base absolute conclusions upon a single examination of an entire
water supply, and a second examination would enable me to
gauge more correctly of the exact condition of the water. This
should be made after an interval of several weeks.
Very respectfully yours,
WM. ROYAL STOKES.
Ill a letter from Dr. Pate, dated Deceitiber 28, 1896, he
says :
•' I have examined two samples from the Charlotte
supply, both remarkable for their bacteriological purity."
Since this investigation was made the Charlotte water
works have been purchased by the city.
CONCORD.
RKPORT OF BACTERIOLOGICAL EXAMINATION.
Gibson Station. N. C. October 12, 1896.
To Dr. Young, Concord.
The sample collected by you from the public water supply of
Concord, September 25, contains 600 bacteria to the cubic centime-tre
of water. It contains both proteus aad intestinal baccilli. In
point of numbers the water is fair, but in quality of bacteria had.
The indications are that if you will clean up your water shed,
and stop all sources of fecal eontautii nation, you would have fine
drinking water.
Yours truly.
Duplicate. W. T. PATE.
Gibson Station, N. C, December 1, 1896.
Dr. Young, Concord.
The sample of water sent by you from the public water supply
of Concord, November 10, contains 620 bacteria to the cubic
centimetre of water. No intestinal bacilli. Proteus vulgaris pre-sent.
This is better water than the sample sent September 25,
but is not considered above suspicion.
Yours truly.
W. T. PATE.
DURHAM.
Dt'RHAM, N. (J., September 5, 1896.
Dr. J. M. Manning, Superintendent of Health.
Dear Sir:—In making a quantitative examination of the
sample of water collected and sent me by you on September 2,
1896. I have the honor to submit the following report : A quan-
SIXTH BIENNIAL RIOPORT. 67
titutive analysiis shows 128 colonies to the cubic centimetre.
This nuiuber indicates that tlie water is good, if all the bacteria
are of benign form, and I have no reason to doubt that they are,
from the tests used. Respectfullj' submitted,
Duplicate. ALBERT ANDERSON.
FAYETTEVILLE.
REPORT OF BACTERIOLOGICAL EXAMINATION.
Gibson Station, N. C, Nov. 10, 1896.
Dr. Leiois. Secretary North Carolina Board of Health,
Raleigh, N. C.
Dear Doctor :—As requested by you about October 1, 1 visited
Fayetteville October 27, and collected a sample of water from the
public water supply for examination. I called at the ofBce of
Superintendent of Health twice during the day, but did not find
him in. Dr. McNeill kindly took me out to the water works pond
and placed me under obligation to him for many favors.
Fayetteville has the possibilities of an ideal water supply. The
source is a bold sand hill branch, rising from springs among
the hills in the woods, flowing (without any surrounding
swamp) over a coarse sand and gravelly bed to a short
pond one and a-half miles northwest from the town. From
the pond it is pumped through iron pipes to the town.
The stand-pipe is on the summit of a hill (" Haymount "')
and gives a full pressure. The water shed proper is narrow and
short, has a sandy soil, timbered with scrubby oak and a few old-field
pine, and covered with tra^h that has drifted into heaps in
many places. There are four houses on the water shed, two
cabins, one farm house and the keeper's house. Stock have free
access to the pond. I noticed tlie droppings of cattle within
thirty feet of the intake.
With the expenditure of a small amount this water supply could
be placed above suspicion. It would be necess

LIBRARY
OF THE
UNIVERSITY OF NORTH CAROLINA,
Endowed by the Dialectic and Philanthropic Societies.
Alcove Shelf
VJ/\
SIXTH BIENNIAL EEPOKT
NORTH CAROLINA
BOARD OF HEALTH.
1895-1896.
WINSTON:
M. I. & J. C. Stewart, Pdblic Printers and Binders.
1897.
aiD'f^d
MEMBERS OF THE BOARD.
ELECTED BY THE MEDICAL SOCIETY OF THE STATE OF
NORTH CAROLINA.
Oeorge GriLLETT Thomas, M. D., President Wilmington.
Term Expii'es 1897.
S. Wbstray Battle, M. D Asheville.
Term Expires 1897.
W. H. Harrell, M. D Williamston.
Term Expires 1897.
John Whitehead, M. D Salisbury.
Term Expires 1897.
APPOINTED BY THE GOVERNOR.
W. P. Beall, M. D Grreensboro.
Terra Expires 1897.
W. J. LuMSDEN, M. D Elizabeth City.
Term Expires 1897.
F. P. Venable, Ph. D., F. C. S Chapel Hill.
Term Bxpii'es 1897.
John C. Chase, Sanitary Engineer Wilmington.
Terra Bxpii'es 1897.
Richard H. Lewis, M. D., Secretary Raleigh.
Term Expires 1897.
1
STANDING COMMITTEES.
Epidemics—Drs. Lewis and Whitehead.
Water Supply and Drainage—Dr. Thomas and Mr. Chase.
Hygienics of Public Schools—Drs. Whitehead and Lumsden.
Climatology—Dr. S. W. Battle.
Adulteration of Food and Medicines—Prof. F. P. Venable.
Sanitary Condition of State Institutions—Drs. Harrell
and Beall.
Vital Statistics—Drs. Lewis, Thomas and Harrell.
LIST OF COUNTY SUPERINTEXDENTS OF HEALTH IN
THE STATE OF NORTH CAROLINA, DECEMBER 31, 1896.
Alamance—Dr. R. A. Freeman, Burlington.
Alexander—Dr. T. F. Stevenson, Taylorsville.
Alleghany—Dr. Robert Thompson, Sparta.
Anson—Dr. E. S. Ashe, Wadesboro.
Ashe—Dr. L. C. Gentry, Jefferson.
Beaufort—Dr. Joshua Tayloe, Washington.
Bertie—Dr. H. V. Dunstan, AVindsor.
Bladen—Dr. Newton Robinson, Elizabethtown.
Brunswick—Dr. D. I. Watson, Soutbport.
Buncombe—Dr. E. C. Starnes, Asheville.
Burke—Dr. J. L. Laxton, Morganton.
Cabarrus—Dr. Robert S. Young, Concord.
Caldwell—Dr. A. A. Kent, Lenoir.
Camden—
Carteret—Dr. George N. Ennet, Beaufort.
Caswell—Dr. W. O- Spencer, Yanceyville.
Catawba—Dr. D. McD. Yount, Newton.
Chatham—Dr. J. Baxter Matthews, Pittsboro.
Cherokee—Dr.-J. F. Abernathy, Muri^hy.
Chowan—Dr. R. H. AVinborne, Roekyhock.
Clay—Dr. W. E. Sandei-son, Hayesville.
Cleveland—Dr. O. P. Gardner, Shelby.
Columbus—Dr. I. Jackson, Whiteville.
Crayen—Dr. J. W. Duguid, Newbern.
Cumberland—Dr. J. Vance McGougan, Fayetteville.
Currituck—
Dare—Dr. W. B. Fearing, Manteo.
Davidson—Dr. John Thames, Lexington.
Davie—Dr. James McGuire, Mocksville.
Duplin— Dr. J. C. Grady, Magnolia.
Durham—Dr. John M. Manning, Durham.
Ed&ecombe—Dr. L. L. Staton, Tarboro.
Forsyth—Dr. E. F. Strickland, Bethania.
Franklin—Dr. E. S. Foster, Louisburg.
Gaston—Dr. J. H. Jenkins, Dallas.
Gates—
Graham— •
Granville—Dr. T. L. Booth, Oxford.
Greene—Dr. Jos. E. Grimsley, Snow Hill.
Guilford—Dr. W. J. Richardson, Greensboro.
LIST OF SUPERINTENDENTS OF HEALTH.
Halifax—Dr. I. E. Grreen, Weldon.
Harnett—
Haywood—Dr. J. Ho^yell Way, Waynesville.
Henderson—
Hertford—Dr. John W. Tayloe, Union.
Hyde-
Iredell—Dr. W. J. Hill, Statesville.
Jackson—Dr. W. F. Tompkins, Webster.
Johnston—Dr. R. J. Noble, Selma.
Jones-
Lenoir—Dr. James W. Parrott, Kinston,
Lincoln—Dr. Thomas F. Costner, Lincolnton.
Macon—Dr. S. H. Lyle, Franklin.
Madison—Dr. James K. Hardwieke, Marshall.
Martin—Dr. W. H. Harrell, Williamston.
McDowell—Dr. George I. White, Marion.
Mecklenburg—Dr. H. M. Wilder, Charlotte.
Mitchell—Dr. C. E. Smith, Bakersville.
MoNTGrOMERY—Dr. W. A. Simmons, Troy.
Moore—Dr. Gilbert McLeod, Carthage.
Nash—Dr. J. J. Mann, Nashville.
New Hanoa'ER—Dr. J. C. Shepard, Wilmington.
Northampton—Dr. H. W. Lewis, Jackson.
Onslow—Dr. E. L. Cox, Jacksonville.
Orange—Dr. D. C. Parris, Hillsboro.
Pamlico—
Pasquotank—Dr. J. E. Wood, Elizabeth City.
Pender—Dr. George F. Lucas, Currie.
Perquimans—Dr. C. C. Winslow, Winfall.
Person—Dr. J. A. Wise, Roxboro.
Pitt—Dr. Frank W. Brown, Greenville.
Polk—Dr. C. J. KenAvorthy, Tryon.
Randolph—Dr. T. T. Ferree, Ashboro.
Richmond—Dr. W. H. Steele, Rockingham.
Robeson—Dr. T. A. Norment, Jr., Lumberton.
Rockingham—Dr. D. W. Courts, Reidsville.
Rowan—Dr. John Whitehead, Salisbury.
Rutherford—Dr. E. B. Harris, Rutherfordton.
Sampson—Dr. John A. Stevens, Clinton.
Stanly—Dr. D. P. Whitley, Millingport.
Stokes—Dr. W. L. McCanless, Danbury.
Surry—Dr. 'John R. Woltz, Dobson.
Swain—Dr. A. M. Bennett, Bryson City.
Transylvania—Dr. M. M. King, Brevard.
Tyrrell—Dr. B. W. Cohn, Columbia.
LIST OF SUPERINTENDENTS OF HEALTH.
Union—Dr. J. E. Ashcraft, Monroe.
Vance—Dr. J. H. Tucker, Henderson.
Wake—Dr. P. E. Hines, Raleigh.
Warren—Dr. Geo. A. Foote, Warrenton.
Washington-
Watauga—Dr. W. B. Councill, Boone.
Wayne—Dr. W. J. Jones, Jr., Goldsboro.
Wilkes—Dr. J. M. Turner, Wilkesboro.
Wilson—Dr. Nathan Anderson, Wilson.
Yadkin—Dr. T. R. Harding, Yadkinville.
Yancey—Dr. J. L. Ray, Burnsville.
LETTEE OF TRANSMISSION.
North Carolina Board of Health,
Office of the Secretary,
Ealeigh, N. C, January 7, 1897.
«
His Excellency Elias Oarr,
Governor of North Carolina^
Sir:—In accordance with Section 3, Chapter 214, Laws
of 1893, I have the honor to present this the Sixth Bien-nial
Report of the North Carolina Board of Health.
With great respect,
Your obedient servant,
RICHARD H. LEAVIS, M. D.,
Secretary and Treasurer.
SIXTH BIENNIAL REPORT
OF THE
NORTH CAROLINA BOARD OF HEALTH.
1896-1896.
During the past biennial period tlie State has been
greatly blessed in its escape from any serious or wide-spread
epidemic of disease. As an illustration we cite
the fact that not a single case of small-pox has occurred
within our borders, notwithstanding its prevalence in
many widely scattered localities in tlie United States.
We deserve no credit for this, however, for unfortunately
the people as a whole are most discouragingly indiflferent
to the importance of vaccination. As a consequence
thousands—hundreds of thousands, we may say—of our
people are unprotected and present a rich harvest for that
particular messenger of death, should it come to us, as it
may at any hour, atid in the course of time surely will.
But the Board of Health is powerless, beyond offering
advice, which in the absence of imminent danger goes
unheeded, for the reason tiiat under the law it has only
advisory powers and cannot compel obedience to the
plainest and most urgent sanitary rules. Owing to this
want of power our work has been for the last two years,
as in the past, chiefly educational. Our efforts have been
directed to instructing the people in the j)rinciples of
hygiene and impressing upon them the importance and
value, looked at from the money point of view as well as
from tliat of life and comfort, of a proper observance of
8 NORTH CAROLINA BOARD OF HEALTH.
the rules of health. This work has been accomplished
through the instrumentality of letters from the Secretary
in particular cases, the Monthly Bulletin^ health confer-ences,
and the distribution of health pamphlets. Two
" health conferences with the people " have been held since
our last report, one at Washington on the 16th of Xovem-t
»er, 1895, and the other at Charlotte on October 15, 1896.
These w^ere well attended, especially the former, at which
people were turned away for want of room. Much inter-est
in the proceedings, which consisted of the reading of
papers, by members of the Board and others invited by the
Board, of a popular character on practical subjects, the
discussion of the matters thus brought forward and ques
tions by individuals in the audience. Nearly 30,000 each
of three health pamphlets and 20,000 of another have been
distributed. By these means sanitary seed have been sown
broadcast from Cherokee to Currituck, and although many
fell by the wayside or on stony ground or among thorns,
some have fallen on good ground and brought forth fruit.
While we cannot claim to have yet secured a good "stand"
the field grows greener with each succeeding year and
the prospect of a harvest more encouraging.
A detailed statement of the work of the Board since our
last report will be found in the following pages.
MEETINGS OF THE BOARD.
CALLED MEETING AT EALEIGH,
January 29, 1895.
In the absence of a quornni an informal consultation
by the three members present, viz. : Drs. Thomas. Harrell
and Yenable, besides the Secretary, was held with the last
named in regard to sanitary legislation by the General
Assembly then in session.
MINUTES OF THE ANNUAL MEETING AT
GOLDS BOPtO, IN 1895.
GoLDSBORO, N. C., May 15, 1895.
The Board met in annual session. Piesent, President
Thomas, Drs. Harrell and Yenable, and the Secretary.
The minutes of the last meeting were read and approved.
The term of the President having expired, Dr. George
Gillett Thomas was unanimously reelected.
Upon invitation Drs. Albert Anderson and W. T. Pate,
who had completed the course in practical bacteriology at
the laboratory of the United States Marine Hospital serv-ice
under Passed Assistant Surgeon, J. J. Kinyoun—this
privilege having been extended to them by the Board
upon the offer of the Marine Hospital service—appeared
before the meeting. The question as to the best arrange-ment
to be made betw^een them and the Board in regard
to bacteriological examinations was mutually discussed.
It was finally decided that they should provide all their
10 NORTH CAKOLINA BOARD OF HEALTH.
apparatus and that the Board would pay them for work
done. They were requested to submit a schedule of
charges.
Upon motion the secretary was instructed in view of the
absence of a quorum to submit a copy of the proceedings
of this meeting to the absent members by letter for their
approval or disapproval.
On motion Washington was selected as the place for
holding the next healtii conference in October, the exact
date to be set by the President.
On motion two hundred dollars per annum were appro-priated
for clerical help to the Secretary.
On motion the action of the Secretary in having 10,000
copies of " Instructions for Quarantine and Disinfection '^
printed for distribution with the other health pamphlets
was endorsed.
On motion the Secretary was instructed to have printed
in pamphlet fnrm the paper on " Typhoid Fever" read by
Dr.. A. R. Wilson, of Greensboro, before the Salisbury
• Health Conference, together with the secnon of the law
bearing on that disease, for general distribution.
On motion the Secretary was authorized to have printed
as many copies of the several health pamphlets as in hi&
judgment could be distributed to advantage.
The Treasurer, on motion, was given permission to
send his report by mail to the auditing committee, com-posed
of Drs. Tenable and Harrell.
On motion the Board adjourned.
RICHARD H. LEWIS,
Secretary.
In compliance with the instructions above given the
following letter was sent to all tiie members of the Board
who were not present at the meeting, and their replies
unanimously approving the action taken by those present
are on file in the Secretary's office.
sixth biennial report. 11
North Carolina Board of Health,
Raleigh, October 21, 1895.
Dear Doctor :—At the Goldsboro meeting, on May 15th, it was
moved that in view of the fact of a want of a quorum, the Sec-retary
be instructed to submit by letter a copy of these proceed-ings
to the absent members of the Board for tlieir approval or dis-approval,
in order to make effective any action that may be
taken.
Drs. Thomas, Harrell, Venable and the Secretary were present.
Anderson and Pate appeared before the Board by invitation, and
the best arrangement as to bacteriological work by them for the
Board was discussed. It was decided to pay them for the work
done, and they were requested to submit to the Board a schedule
of charges. Dr. Gr. Gr. Thomas was unanimously re-elected Presi-dent.
Washington was selected as the place for the next Health
Conference, the date in October to be set by the President. On
motion it was ordered that $200 per annum be appropriated for
clerical help to the Secretary. The action of the Secretary in hav-ing
printed 10,000 copies of instructions for quarantine and disin-fection
for distribution with the other health pamphlets was
approved. He was instructed to have printed for general distri-bution
Dr. A. R. Wilson's paper on " The Importance of Disin-fecting
the Bowel Discharges in Typhoid Fever." He was also
authorized to have printed as many additional copies of all the
pamphlets as he might think advisable. The Treasurer was
given permission to send his report by mail to the auditing com-mittee,
composed of Drs. Harrell and Venable.
Please let me have your report on the above by return mail and
oblige.
Yours very truU%
RICH'D H. LEWIS,
Secretary.
MmUTES OF THE MEETING AT AVASHINGTON,
NOVEMBER 6, 1895.
Hotel Nicholson,
Washington, N. C, November 6, 1S95.
After the adjournineiit of tlie Health Conference, which
was a pronounced success, the Board met in private ses-sion.
Present, Drs. Harrell and Venable, Mr. Chase and
the Secretary. In the absence of the President Dr. Har-
12 NORTH CAROLINA BOARD OF HEALTH.
rell was called to the chair. There being no quorum no
formal business was transacted, but a general discussion
of future work for the Board was had. Dr. Harrell handed
in the Treasurer's report, approved by himself and Dr.
Yenable, the auditing committee.
KICH'D H. LEWIS,
Secretary.
MINUTES OF THE ANNUAL MEETING AT
WINSTON IN 1896.
Phcenix Hotel, Winston, N. C, May 12, 1896.
The annual meeting was called to order by President
Thomas. Present, Drs. Thomas, Battle, Harrell, Lums-den,
Venable and Lewis—and Dr. P. L. Murphy of the
State Hos])ital by invitation.
On motion the reading of the minutes of the last meet-ing
was postponed.
The question of the best place for the next health con-ference
coming up, Charlotte was selected—the time to be
set by the Secretary after conference with the President
of the Board and the local physicians.
On motion it was decided to have made during the year,
by committees to be appointed by the President, an
inspection of all the public institutions and convict camps.
The advisability of quaratitining measles was discussed.
It was decided that it would be wisest not to attem.pt to
enforce it.
The subject of further distribution of health pamphlets
was considered but no action taken.
The care of the incurable insane of the State was like-wise
discussed at considerable length.
On motion the Board adjourned to meet again to-morrow.
RICHARD H. LEWIS,
Secretary.
SIXTH BIENNIAL REPORT. 13
Phcenix Hotel, Winston, N. C, May 13, 1896.
Pursuant to adjournment last evening the Board met,
with Dr. Harrell presiding, in the temporary absence of
the President. The President coming in resumed the
chair. Present, Drs. Thomas, Harrell, Whitehead, Yen-able,
Lumsden and Lewis.
On motion another edition of the present health pam-phlets,
together with Dr. Yenable's paper on "Impurities
in Drinking Water," Mr. Chase's on "Sanitary Drainage
and Disposal of Household Wastes " and the paper on
" The Care of the Eyes and Ears," written some years ago
at the request of the Board by the present Secretary and
stereotyped at that time by the then Secretary, Dr. Wood,
of 20,000 or more copies in the discretion of the Secretary,
was ordered printed, bound in one volume and distributed.
On motion it was ordered that a chemical and bacterio-logical
examination be made of the public municipal water
supplies of the State. Dr. Yenable kindly offered to
make for the Board one chemical analysis of each supply.
The question of having an examination made of the water
supplies of the public institutions was dii^cussed, and left
for decision to the visiting committees.
On motion Dr. P. L. Murphy, Superintendent of the
State Hospital at Morganton, was requested to prepare
and read before the proposed health conference at Char-lotte
a popular article on the importance and best method
of caring for the incurable insane of the State.
The Secretary and another member of the Board, to be
appointed by the President, were selected as delegates to
the annual meetine; of the American Public Health Asso-ciation
at Buffalo in September.
Dr. Yenable, who was appointed a committee to audit
the accounts of the Treasurer, reported them correct.
On motion the Board adjourned to meet at Charlotte.
RICHAPvD H. LEWIS,
Secretary^
14 NORTH CAROLINA BOARD OF HEALTH.
MINUTES OF THE MEETING AT CHARLOTTE
IN OCTOBER, 1896.
Charlotte, N. C, October 15, 1896.
In one of the intervals between the meetings of the
Health Conference a business meeting of the Board was
held in the Buford House. All the members, except
Dr. Harrell, who was detained at home by sickness in his
family, were present. Passed Assistant Surgeon J. J.
Kinyoun, of the Marine Hospital Service, and Dr. Mnrphy,
of the State Hospital at Morganton, were also present by
invitation.
The Secretary presented the reports of Drs. Anderson
and Pate, the bacteriologists of the Board, of their exam-inations
of the water supplies of Asheville, Salisbury,
Concord, Greensboro, Salem, "Winston, Durham, Raleigh,
Henderson, Goldsboro, Wilmington and Newbern, and
stated that he had been unable to obtain, up to that time,
through the usual channels, proper samples from Charlotte
and Fayetteville. He called attention to the fact that five
of these supplies were reported as infected with intestinal
bacilli and three as being suspicious.
On motion, the Secretary was instructed to have made
immediately another bacteriological and chemical examina-tion
of all the infected and suspicious waters ; and lie was
further ordered in fliose cases where the water was shown
to be still bad, to notify the Superintendent of Health, the
Mayor and the Manager of the Water Works of the fact,
and call upon them in the interest of the public health to
remedy the trouble, and if he did not receive satisfactory
assurances within 30 days that this had been done, to have
the analyses published in the local papers for the informa-tion
of the people using said waters.
An offer to the Board by Dr. R. H. Whitehead, the
head of the Medical Department of the State University,
to make free of charge the serum diagnosis test for typhoid
SIXTH BIENNIAL REPOKT. 15
fever for physicians desiring it, was presentee'. On
motion, Dr. Whiteliead's kind offer was accepted with
thanks, and the Secretary authorized to distribute the
necessary information among the profession of the State,
to make it effective.
A letter from Dr. Munroe, asking that the Engineer of
the Board be sent to Davidson College to advise as to the
best disposal of the sewage from the new medical building-there
was read. On motion, Mr. Chase was requested to
visit Davidson and give all sanitary advice that might be
indicated. He was also requested to make a sanitary
inspection of the Orphan Asylum at Oxford.
Resolutions of thanks to Dr. Kinyoun for his interesting
address on " Bacteria " to the Conference, and to Dr.
Murphy for his excellent paper on the " Care of the
Insane," were adopted. On motion, the Secretary was
instructed to have 5,000 copies of the latter printed and
distributed for the information of the people on this
important subject.
On motion, the Board adjourned.
RICH'D H. LEWIS,
Secretary.
16 NORTH CAROLINA BOARD OF HEALTH.
PROCEEDINGS
OF THE
CONJOINT SESSIONS OF THE STATE BOARD OF HEALTH
WITH THE
State Medical Society in 1895 and 1896.
The Conjoint Session at Goldsboro, Mat 15, 1895.
The Conjoint Session was called to order at 12 o'clock
by the President, Dr. Geo. G. Thomas, of Wilmington.
The President stated that the expiration of the terms of
Dr. W. H. Harrell, of Williamston, and Dr. John White-head,
of Salisbury, made it necessary to go into an election
for members to fill their places.
Dr. W. H. Harrell, of Williamston, and Dr. John AVhite-head,
of Salisbury, were nnanimonsly elected to succeed
themselves in office.
Dr. R. H. Lewis, the Secretary, read his report.
ANNUAL REPORT OF THE SECRETARY OF THE
NORTH CAROLINA BOARD OF HEALTH
FOR THE YEAR 1891-'95.
The law of the State requires the Secretary of the Board
of Health to make biennially to the General Assembly,
through the Governor, a report of their work. He is also
required by the Board to make to its conjoint session with
the State Medical Society an annual report. As the
General Assembly and the Society do not meet- at the
SIXTH BIENNIAL REPORT. 17
same time the periods embraced in these reports are not
synchronous, and the result is that the biennial report
overlaps and includes a large part of the report which is
made to you in odd years. In consequence of this fact the
report of our work for the period embraced between our
last meeting and January 1, 1895, has already been pub-lished
in the Fifth Biennial Report to the General As-sembly,
copies of which you will find on the desk of the
Secretary of the Society.
Since the first of the current calendar year c-oniiiara-tively
little new work has been undertaken. With a
Legislature dominated by a new element in our State
politics whose attitude towards the public institutions in
general, and the Board of Health in particular, was un-known,
it was thought to be wisest to pursue a Fabian
policy, lest our being too rfiuch in evidence might bring
disaster upon the labor of years. It is extremely trra-tify-ing
to be able to say that our fears proved to be entirely
groundless. This mattei having alread}- been set forth in
the Report of the Committee on Legislation no farther
refereni-e to it is required.
The most successful and in every way encouraging
meeting tlie Board has ever held was that '' with the
people " at the Salisbury Health Conference in September
last. A full account of the proceedings wi'l be found in
the appendix to the Biennial Report. Among the papers
read on that occasion were, one entitled "Suggestions on
the Prevention of Tuberculosis as We Know it To-day,"
by Dr. S. West ray Battle, of the Boaid, and another on
" Drinking AYater in its Relation to Malarial Diseases,"
by the Secretary. These papers were ordered by the
Board to be published in pamphlet form for general dis-tribution,
and I had 10,000 copies of each printed from
the type already set up f^r the Biennial Report. Feeling
that the people needed instruction in regard to the inij)ort-
2
18 NORTH CAROLINA BOARD OF HEALTH.
ance of quarantine and disinfection in contagions diseases
as well as in the matters of tuberculosis and malaria, and
that we should take advantage of the opportunity to
widely spread such information at a trifling cost, I took
the responsibility of having the same number of " Instruc-tions
for Quarantine and Disinfection" reprinted. I
began the distribution by sending a set of the pamphlets
to all newspapers in the State with the following letter :
Dear Sir :—I send you by this mail, under separate cover,
copies of two pamphlets published by the Board for general dis-tribution
entitled "Suggestions on the Prevention of Tubercu-losis
as we Know it To day,'" and " Drinking Water in its Relation
to Malarial Diseases." If they meet with your approval I would
thank you to notice them in your paper, and especially to notify
your readers that I would be verj' glad to send them just as many
copies as they will read or agree to distribute among their neigh-bors.
The widest distribution possible of these publications is
desired. Anything you can do to help the Board in their work of
preventing disease will be highly appreciated by them and by.
Tours very truly,
R. H. LEWIS, M. D., Secretary.
Xot having af•ce^s to most of the papers I cannot tell to
what exteut the request was complied with, but a number
CMiirHining the desired notice have been sent me, and no
don lit many others were equally kiiid.
In order to extend as much as possible the distribution
I prepared and had printed 10,000 copies of a circular
letter to our i;)hysicians.
With a view to an accurate distribution I returned to
the Clerks of Court of all the counties in the State for re-visal
and correction in the lists of registered physicians
kindly sent me by them in response to my request^ two
years ago. All have been sent back except thirteen. To
every registered physician in the other 83 counties I have
mailed a copy of each of the three pamphlets and the cir-cular
letter, and will mail them to those in the other thir-teen
as soon as the lists, for which I have written again,
SIXTH BIENNIAL REPORT. 19
come in. To all County Superintendents I have sent
them in quantity, and also to those who have written for
them with a promise to distribute them. In order to in-sure
the thorough dissemination of the information on all
the subjects treated of in the three pamphlets I have en-closed
in each large package a copy of this circular letter :
Dear Sir :—I send you a number of copies of " Prevention of
Tuberculosis as we Know it To-day," " Drinking Water in its Rela-lation
to Malarial Diseases," "Instructions for Quarantine and
Disinfection," and circular letter for distribution. As the Board
desires to disseminate the information contained in each as widely
as possible amone: the people I would thank you to give to each
person a complete set of all four. Although a pei'son may express
a desire for only one, give him all of them.
If you find you can distribute more let me know and I will take
much pleasure in replenishing your stock. Any efforts to help us
in this work would be greatly appreciated by the Board.
Very truly yours,
RICHARD H. LEWIS, M. D , Secretary.
That the publications liave been received with much
favor is evident from the newspaper notices, which some
of you have doubtless seen, and still more from the num-ber
of applications which I have received for them in re-sponse
to the circular letter, and the invitation published
in many of the newspapers, perhaps all of them. The ex-act
number asked for so far in the applications which give
figures is 4,093, varying in quantity from 1 to " 300 or
more." In addition 22 requests of an indefinite character
have come in, such as, for example, " a few," " some," " a
great many," " as mar)y as you may please to send," " as
many as you can spare," " enough to supply the drug
stores of Fayetteville," " a sufticient quantity for a crowd
of a thousand expected at the closing exercises of a
school," etc. The ten thousand have been already nearly
exhausted and the present demand has not by any means
been supplied. I believe that 60,000 could be scattered
through the State with benefit fur the education of the
20 NORTH CAROLINA BOARD OF HEALTH.
people in these practical sanitary questions. Something
on typhoid fever should accompany the publications men-tioned
above. AVe already have it in hand in an admir-able
article on that subject read before the Salisbury
Health Conference by Dr. A. R. Wilson, the live and
energetic Superintendent of Guilford County, which you
will find in the proceedings of that meeting printed in the
appendix to the Biennial Report. With the sections of
the law especially applying to typhoid fever as 'an adden-dum
that paper would I am sure do much good. I trust
that it may be the pleasure of the Board to order it
*
printed in the same form and sent out with the others
hereafter.
If it meet with the approval of the Board it is my inten-tion
to send these pamphlets to all the State and County
officers, to the professors in all our colleges and high
schools, to every lawyer, especially to every preacher, that
he may be incited to preach in private to his flock the
gospel of physical health, to leading farmers and mer-chants
and to every one who shall ask for them. But after
all no class of our citizens can advance the cause of pre-ventive
medi(;ine as can our physicians, for the simple
reason that they aloue can speak ex cathedra. It is, how-ever,
a very discouraging fact that many are quite indif-ferent
to the claims of this branch of our calling, and I
avail myself of the opportunity aiforded by this conjoint
session to again appeal to you to lend a hand and help to
build up in the profession generally a sentiment favorable
to the active promotion of that which has in it such poten-tialities
for good to all the people. We have received
gratifying assurances from various sources that the work
done in the past year has been the most successful in the
history of the Board of Health. With the cordial support
and active co-operation of the medical men of the State
SIXTH BIENNIAL KEPORT. 21
we can confidently look forward to far o-reater results.
Without it our best directed and most earnest efforts
must prove largely barren and unprofitable.
It will be remembered that the U. S. Marine Hospital
Service, through Passed Assistant Surgeon J.J. Kinyoun
extended an invitation to our Board at the last annual
meeting, at Greensboro, to send representatives to Wash-ington
for the purpose of receiving free a six weeks course
of instruction in practical sanitary biology, in the hibora-tory
of the Service.
I am gratified to report that Dr. Albert Andert-un, of
AVilson, and Dr. W. T. Pate, of Gibson Station, applied
for the privilege, and in January last availed themselves
of it. They report a very satisfactory experience, and
are now fully equal to the bacteriological examinations
called for in practical sanitation. They desire to make
some return for the privilege enjoyed through the cour-tesy
of our Board by doing a reasonable amount of work
for us without charge. Dr. J. Howell Way, of Waynes-ville,
has recently made application to the Board for an
appointment to the Laboratory, and as soon as it may
mutually suit the convenience of himself and the Superin-tendent
of the Laboratory it will be given him.
The invitation is open to any member of the Society as
long as the offer of the Marine Hospital Service in this
matter stands. . ,
DISCUSSION.
Dr. Haigh said that in ]^is section of country there had
been a great deal of interest taken in sanitation, and espe-cially
in regard to the supplj' of water. Of late years the
malarial cases had assumed a more serious form, that of
hemorrhagic fever. The simple driven pump is not hav-ing
the full effect expected, that is, not giving freedom
from surface water. He wished all the information he
could get upon the subject. He had never seen the peo-
22 NORTH CAROLINA BOAED OF HEALTH.
•
pie take more interest in matters cominpj from the State
Board of Health. He was sure that the profession would
help the Board in every way in distributing these tracts.
Dr. Booth was glad that the Board was holding meet-ino-
s ronnd through the State, and he thought that the
Board was doing a great work.
The report of the Secretary was received.
Dr. Geo. H. AYest presented, through the Secretary, a
paper on the •' Influence of AVater on Malarial Fever." It
was read by title and referred.
The Secretary stated that Dr. West reported his experi-ence
as a physician to the convict camps on the Roanoke
river. He had found a marked diff'erence in the amount
of malaria caused from the driven pump and the open
well. The desire is to get through the impervious layer
of marl and clay ; but he had found tlie malaria very much
diminished by wells 25 or 30 feet deep, tho' not through the
marl or clay. The Secretary reported a letter he had gotten
from Dr. Whitaker, the County Superintendent of Jones
county, of Trenton. Dr. AVliitaker said in his letter that
Trenton was situated oti a ridge, with the river on one side
and a mill-pond on the otiier. The people on the ridge rarely
ever suifered from malarial troubles, but there was one
well on the slope—the people who drank from it suflered
very much from malarial diseases. The dam of the pond
broke in the spring and was^n/)t repaired until the follow-ing
fall, and the bottom of that pond lay exposed to tlie
suns of that summer on the South side of the town during
the entire season, and there was no increase whatever in
the amount of malaria in the town. Dr. AYhitaker him-self
and others fished in the little pi)ols without the slight-est
hesitation and never had any malarial fever. He said
that afterwards something got the matter with the mill
and the owner turned off the water in order to repair his
mill, and the consequence was deep indignation on the
SIXTH BIENNIAL REPORT. 23
part of the people of Ti-enton ; but, instead of an increase
in the amonnt of malaria during that August and Septem-ber,
if there was any difierence at all, there was less than
there wms before.
The President reported a series of cases from Jackson-ville,
N. C, bearing upon this qnestion. The town is
practically enclosed by New River ; it is in Onslow county.
On the point of this peninsula is situated a large saw-milling
plant. These patients (all young men), having
been warned of the dangers, had used Apollinaris and
otlier bottled spring waters. All of the water was abso-lutely
protected, but they had frequent and severe attacks
of malaria. He suggested to these youno; men tliat, in
addition to the care they exercised, they insist upon their
cook boiling everv day the water used in cooking their
food that came from a well outside 140 feet deep. It went
down through the mud layer and the layer of sand and
layer of clay. So far the experiment of bniling the water
has done very well. One of the young gentlemen has liad
occasional outbreak of malaria. There has been ro sign
of an outbreak among the others since tlie boiling began.
Dr. O. McMullan said that he had read Dr. Lewih' pam-phlet.
His experience ran back some twelve years or more
in the eastern part of the country, and it went to show
that malarial troubles were greatly diminished in 1S84
and 1885, when there were very little. Frequently tiirough
whole years only four or five cases are heard of. The peo-ple
all improved when the open wells and springs were
first substituted by driven pumps; but the chills are all
coming back again. In the year 1893 there was a decided
change, and in the spring the people all over the country
began to have chills. He thought t'^at there must be some
fallacy in the theory that the water was the cause of tlie
chills and fever.
Dr. Sikes wished to corroborate what had just been said.
24 NORTH CAROLINA BOARD OF HEALTH.
In the year 1882 nearly everybody in the hill 'country had
chills. Then they had no more chills, except a few up
and down the border of a swamp, until 1894. They did
not have any pumps nor make any change, drinking the
same water and exposed to the same causes all the time.
Chills come in his country by epidemics.
Dr. Duffy did not wish to detract anything from the
importance of a good supply of drinking water, but he did
wish to say something in favor of bad air as a possible
cause. He related the history of a set of cases that fell
under his observation last year. At a place five miles from
Xewbern, known as Fay's Mill, the pond had become dry,
and had been so for several years. A stream of water ran
through the bed. A family lived there on the verge of
that mill-pond and drank from a spring that ran from a
rock. That was the only water they used, and the most
malignant case of malarial fever that he saw during that
year was in tliat family. One patient was totally uncon-scious
from having convulsions. Fortunately, he had a
supply of Sharp & Dohme's bimuriate of quinine for hypo-dennic
injection, and he recovered. There were a number
of cases in that family. While he did not think that the
importance of good wells could l)e exaggerated, still he
thought that an eye ousht to be kept on' bad air also.
Dr. Lewis said that those who had read his pamphlet
would bear in mind that he did not commit himself
entirely to tlie water theory, but at the same time it was
written from the point of view of an advocate, and that
he had deliberately overlooked, so far as he could, any
evidence on the other side. He did it because if the peo-ple
were given any avenue of escape they would take it,
and he left out a good deal of evidence on purpose.
He was surprised to note that the word cistern had been
left entirely out of the discussion. He was a stronger
advocate of tlie cistern than of the driven well, but failing
the cistern he advocated the driven well.
SIXTH BIEXNIAL REPORT. 25
Dr. Lewis was asked if he thought the malarial germ
could go seventy-five or eiglity feet below the surface.
He said he believed it not impossible for the germ to go
down the side of the pipe.
Dr. Pate said that there are other things about the well
beside malarial poison. Tiie old bucket and the old svs^eep
system are very frequently the cause of the infection of
the water by typhoid fever and other germs. It was
almost impossible to get a washerwoman who could not go
and wash the poison from her hands into the well by
handling the chain or pole after they had been infected by
the soiled clothes. He was sure that he had seen cases of
typhoid fever arising from that source, and he recom-mended
the bored well to ])revent that infection as well as
others.
Dr. Haigh asked about the leports of health from the
different counties. The death-rates of several small places
had been so high that they attracted his attention, and he
asked if there was any special cause.
Dr. Lewis, in answering, read the reports and explained
that tlie death-rates appearing monthly in the Bulletin
were merely temporary. Many of the returns were worth-less
on account of the town authorities not taking proper
care to render the reports accurate. In one town there
are some 3,500 negroes, and months and months will pass
without a single death of a negro reported. That is
because the regulations in regard to statistics of deaths are
not carried out. The only way to make the statistics accu-rate
is not to allow a dead body to be removed until a
death certificate has been signed by a physician or a nuig- ,
istrate. A report under l2 per thousand he considered
worthless.
The President did not consider the statistics as worth
anything, but could see no way at present to enforce the
26 NORTH CAROLINA BOARD OF HEALTH.
laws. Many valuable points could be brought out and
very simple certificate. It ought to cover not only the
age and race, but the place of birth and how long the per-son
had resided in the place of his death. It would affect
the sanitary history of a town very materially. A person
coming to a town and dying in a month of something con-tracted
before, affects the death-rate of a town and its san-itary
histoi'y very injuriously.
That brings up aiK)ther very important subject—that of
acclimatization of foreigners. In looking over the deaths
from yellow fever he had noticed that Germans died more
rapidly than any others. A great many people died of
so-called bilious fever of the ty]>e in Wood's Practice.
Dr. Guiteras, in studying the nature of the fevers of the
South, believed some of these were cases of yellow fever
unrecognized, and he says that a large portion of the proof
is based upon the fact that newly arrived emigrants died
of it.
The Conjoint Session then adjourned.
GEO. GILLETT THOMAS, M. D., PresidenL
Richard H. Lewis, M. D., Secretary.
SIXTH BIENNIAL REPORT. 27
CONJOINT SESSION AT WINSTON, MAY 63, 1896.
The Conjoint Session was called to order bj Dr. Geo.
Gillett Thomas, President of tlie Board of Health.
At the first order of business the session listened to the
following address of the President
:
The cause of preventive medicine, wliieh we represent,
is receiving everywhere the increasing support of the laity
and the law-makers; and it behooves us, therefore, to care-fully
consider all the problems tliat the session may
present to us.
Men of thought and genuine public spirit, men who are
not politicians from any selfish motive save the laudable
ambition of helping and being accounted as promoting all
measures that will bring the greatest good to the greatest
number. Men of scientific attainments, not the mere
scholar and student, but men possessed of knowledge that
they can and do turn to a practical use, all men of great
worth and close observation are flocking to the aid of the
sanitarians.
In proof of this the meeting of the American Public
Health Association is largely composed of laymen, but
they are just as much interested and in earnest as the pro-fessional
men, and the quota of the work which these lay
members furnish is just as important and impressive
as that sent in by tlie members of our medical profession.
AYe feel, therefore, that w(> ought to seriously ask ourselves
if we each and every one are doing all in our power to aid
in the work of the Board of Health of this State.
During the year just ended, your Board of Health has
been less conspicuously employed than in former years,
28 NORTH CAROLINA BOARD OF HEALTH.
but they have been none the less active. Under the
skillful guidance of their most etScient Secretary, Dr. E..
H. Lewis, the work has become more and more system-atized,
and the only flaws of importance in the laws at the
present are the want of more mandatory powers, and more
money to effect the execution of the orders of the Board.
The health meeting at Washington, one of the mission-ary
sanitary conventions, of the purpose and scope of
which you were apprised last year, was a marked success,
and is bearing legitimate fruit right now. These meetings
will be repeated just as often as possible. It must be
remembered that the personnel of the Board is composed
of active practitioners and laymen who are always
intensely engaged. Due consideration for the life work
of these men must be had always in projecting iind carry-ing
into effect one of these meetings. There is no doubt
that the examination of drinking water here and there all
over the State, examinations made to clear up the history
of outbreaks f;f disease, has opened the eyes of the people
to the necessity of more care in the provision of the water
they nse. Coupled with tliis is the work of Dr. Lewis in
the studj' of the connection of malaria with drinking
water. It is quite impossible to measure the extent
of good that is the outcome of his earnest labors in this
field. I know of a certainty that it lias impressed people
who have never heard of or read his excellent monograph,
bnt have come into possession of the facts which he so
admirably set forth. Those of you who saw the exhaustive
report of Dr. Pate on the sample of water sent to him from
"Wilmington, and the clear connection that his examination
established between the drinking water used at a gather-ing
of young people and certain cases of typhoid fever
occurring among them, will realize of how much importance
this new departure of the Board of Health is worth.
I believe that it is a fact that typhoid fever, that deadly
SIXTH BIENNIAL REPORT. 29
scourge, is a preventable disease, and that gradually it
will be so environed by preventive measures that it will
be staniped out. This hope and belief is no doubt to be
realized in a.future more or less distant, but it is a well
founded hope never the less. Tuberculosis, the great
rival of enteric fever, will also be controlled, and materi-ally
lessened, or be made to vanish, as the laws for its
control are gradually evolved from the study and efforts
of the sanitarians. These are not vain hopes or Utopian
dreams. Cholera has been controlled, yellow fever has
been stopped at the border, small pox is isolated and
checked by vaccination, and these are the work of health
authorities.
There is a subject worthy of your serious consideration
both as citizens and physicians. There are, as many, I
might say all, of you know, a large class of insane people
who are classed as incurable, and on account of their
mental troubles they are in some of the counties gather-ing
in the alms house—in others confined in jails, and in
all of the counties a large number of them go about at
large, constituting a menace to the communities in which
they live, as well as often imposing a burden upon the
household that is realh^ unable to care for them. It is
safe to say that no insane person, no matter what the char-acter
of the mental abberation may be, is other than a
dangerous person and liable to do damage at an unlooked
for moment ; or in the case of females become the prey of
brutal men. This subject was presented to you in Raleigh
at the joint session of 1893 by Dr. Hodges, and it is oppor-tune
now to revive it. He did not suggest any plan for
the relief of these dements that was seized upon. It seems
now that something ought to be done,* and to elicit dis-cussion
and an exchange of opinion, I propose that you
consider the propriety of asking the Legislature to pro-vide
district asylums for these people. The general asy-
30 NORTH CAROLINA BOARD OF HEALTH.
liims are not large enough to accommodate them, nor is
there any provision for them in the financial budget of the
State. As you meet them in your rides through the city
streets or along the county roads, or see them in homes,
where they are unwelcome inmates, you often wonder why
some sort of law is not enacted, providing for the isolation
and care of tlie poor helpless creatures.
At present, as I have said, they are cared for in some places
better than others by the County Commissioners and are
pensioners upon the tax-payers. It seems that these dements
could be gathered together j*n groups, as for instance all
of the counties in a congressional district sending their
pauper insane, who cannot be admitted to the general hos-pitals
at Raleigh, Morganton or Goldsboro, to a hospital
to be established at some central point in the district and
maintained b}' the counties comprising this district. If
too many counties were in any of these districts other
divisions of fewer counties might be made. Provisions for
the control and care of these hospitals and the inmates
could be made by a general board of control under the
guidance of the Commissioners of Charities, assessments
to be laid on each county according to the number of
inmates sent. This plan would increase the salaried offic-ers
of the State and unfortunately would necessitate more
political appointments.
This plan or some othe ' should l)e adopted tV-r the care
of these unfortunates, and this would naturally lead up to
the establishment of schools for feeble minded children,
enabling them to be taught to be of some service to them-selves
and to the State. This neglect of these stricken
people has been too long allowed, and their wrongs and
needs cry aloud for redress. We hope to have the matter
seriously considered and to present it again until some
action is taken.
There is another subject that needs legislation.
SIXTH BIENNIAL REPORT. 31
The health resorts of tlie State are growing in number
and importance. Those that have risen to the rank and
dignity of towns are under some sort of medical and muni-cipal
control. But the large majority of these places pro-vide
only for summer visitors, and are under no regu-larly
instituted supervision in matters of hygiene. The
consequence is that sickness of more or less serious nature
is the first thing that arouses these people, the hotel and
boarding house keepers, to the necessity for any care for
their sanitary surroundings. It would seem, therefore,
that any of these resorts where large numbers of our peo-ple
congregete during the hot months of the year, if there
is no responsible health officer to direct matters, that the
Board of Health of the State should have the power to
interfere in behalf of both the householders and visitors
and establish rules and regulations for their safety, with
the power also to infiict penalties for violations or neglect.
Let me thank you for your interest in the work
which, as your delegated authority, we have been doing
and bespeak a continued and increasing interest in the
labors of the Board of Health.
Dr. O'Hagan said :—I am sorry to say that in man}'
instances the position of Health Officer in many counties
is eagerly sought for and competed for by medical men
who have not the honor of the profession at heart nor who
duly appreciate its dignity. It has degenerated down into
a little miserable petty office which has not been properly
remunerated. The suggestion made by Dr. Thomas as to
the sanitary control of mineral springs and health resorts
is, I think, very timely. I beg to suggest to his consider-ation
and that of the Board that there should be some lea;-
islation giving them power to exercise jurisdiction over
large boarding schools throughout the State which, I think,
in at least one instance that I know of, totally disregarded
all sanitary laws. There has been a lamentable neglect
32 NORTH CAROLINA BOARD OF HEALTH.
of control of these institutions as to proper feedina:, sanita-tion
of buildinii and the surroundings, proper lighting, ven-tilation,
etc. In some I know the pupils have not been
properly fed. I know one instance where the water which
was used for ice was taken from a pond which was largely
contaminated by poultry and other living animals, and
large portions of filth, etc., had been piled up during the
winter season for the use of the pupils the following sea-son.
Sanitation was grossly neglected. Then the light-ing
of the study rooms was insufficient and unliealthful,
and the result vcas a great prevalence of eye diseases.
Whether the present sanitary legislation of the State
empowers the Board of Health to pay regular visits I am
not aware, but if it does not give power to control these
matters to some extent, it certainly ought. As to the care
of the insane, I appeal to the members of the Society to
interfere in some way or othei- for the relief of these unfor-tunates.
But even supposing that there was any efficient
legislation, I think that there should be an entire change
in the methods of providing for the care and sustenance of
the unfortunates. We have been spending large sums of
money in completing buildings, and if this money were
properly distributed it would enable us to take care of
twice that number in a more efficient manner. I make
these suggestions, that there should be some means by
which sanitary visits shonld be paid to public schools, that
it should be made the duty of the superintendents of edu"
cation (who are generally unfit for the position) that they
should insist that the light, ventilation and drinking water
should be the best that can be had. In many instances I
know the drinking water is not good. I know that the
light and ventilation is totally insufficient and prejudicial
to study and health. I think that instead of having great
central hospitals like those of Goldsboro and the Raleigh
Insane Asylum, which would involve an enormous expen-
SIXTH BIENNIAL REPORT. 33
ditiire of money, they should be done away with and a
building of more humble degree should be erected in each
Congressional district, and the expenses would come imme-diately
out of the pockets of the people of that Congres-sional
district, and the one who has charge of this building
would be held strictly accountable for the condition of it,
and would be directly under the eye of the friends and
relatives of the unfortunate inmates.
Dr. Murphy agreed with the President that no insane
person conld be considered as safe—they are liable to
become dangerous at any moment. He explained the con.
dition of the buildings at Morganton, and while the cost
per bed at the present time was above $200 probably, tliis
included the original cost of the grounds and executive
buildings. He had mapped out plans whereby additional
quarters could be supplied, on the colonization plan, at
considerably less than $100 per bed. He thought it would
be more economical and more beneficial to provide room at
the existing asylums than provide many separate institu-tions.
The Secretary, Dr. R. H. Lewis, read his annual report.
34 NORTH CAROLINA BOARD OF HEALTH.
EEPORT OF THE SECRETARY OF THE NORTH
CAROLINA BOARD OF HEALTH FOR THE
YEARS 1895-'96.
The past year has been, I ani happy to say, an unevent-ful
one in sanitary matters. No epidemics of disease
liave occurred, and small-pox, which has prevailed, more
or less, over the whole conntry, has passed us by entirely.
Fortunate, indeed, is it that we have escaped such a visi-tation,
for immense numbers of our people remain unvac-cinated,
and your Secretary frankly admits that he cannot
devise any method of materially reducino; the niimber.
The only thing that seems to have any effect whatever is
the actual or supposed presence of the disease in a com-munity,
and whenever a scare is heard of the Superintend-ent
of Health is urged to utilize it to the fullest extent
and vaccinate as many as possible.
But while our work has been chiefly routine, I believe
it has been the most effective in the history of the Board.
It has consisted, in large part, in continuing the distribu-tion
(already inaugurated at our last meeting) throughout
the state, in various ways, of the health pamphlets with
which you are familiar.
In compliance with your instructions, I added to the
pamphlets published up to that time the excellent paper
read before the Salisbury Health Conference by Dr. A. R.
Wilson, of Greensboro, on " The Importance of Disinfect-ing
the Bowel Discharges in Typhoid Fever," supplement-ing
it with the section of the law bearing on that disease,
and a short account of the famous Plymouth epidemic.
Acting upon the authority given me at our last annual
meeting, I had printed 20,000 copies each of these articles :
" Prevention of Tuberculosis," "Drinking Water in Its
Relation to Malarial Diseases," and " Instructions for
SIXTH BIENNIAL KKPORT. 35
Quarantine and Disinfection," and liav'e distributed nearly
all of them. They have been sent to all the newspapers
in the State, all the physicians, all the lawyers, nearly all
the ministers, white and black, public officials, State,
county and municipal, the more prominent teachers, and
to numerous individuals whose names were sent to me in
response to the circular letter enclosed in every package,
askin<>; the reader to send me the name and address of
ever}' one he thought would read them. As the Board
has very wisely, in my liumble opinion, in our present
stage of sanitary development, determined to direct its
efforts mainly to interesting and edu ating the people in
the principles of preventive medicine and impressing
upon them the advantages to be derived from a strict
observance of the laws of health ; and, as large numbers
of our public school teachers, farmers and merchants have
not yet seen them, I would respectfully suggest the advis-ability
of printing another edition of at least 20,000 more.
It would be well to sup[)lement the publications named
above with the excellent papers on "Impurities in Drink-ing
water'" and "Sanitary Drainage and Disposal of
Household Wastes," read at the Washington Health Con-ference
by Dr. F. P. Venable and Mr. J. C. Chase, respec-tively,
and perhaps also with the article on " The Care of
the Eyes and Ears," as it was stereotyped by my lamented
predecessor and the cost of paper and press-work would
not be great. Since it is desirable that instruction should
be given in all the subjects treated, and as our plan has
been to send a complete set to everj^ one, even if he asked
for only one, it would be less expensive and mor» satisfac-tory
in eveiy way to have them all bound together. We
can doubtless have the literature intended for the teachers
of the public schools distributed by the Superintendent of
Public Instruction without cost to the Board, which would
mean a very considerable saving in postage.
36 NORTH CAROLINA BOARD OF HEALTH.
In this contiection yon will be interested to know that
in Se}3teniber last I received a letter from the Rev. Phil-lips
Yerner, of South Carolina, a worthy grandson of the
late Charles Phillips, D. D., for so many years the distin-guished
Professor of Mathematics in our University, who
expected to go shortly as a missionary of the Presbyterian
Church to the Kassai river country, in the Congo Free
State, asking fur the publications of our Board on the sub-ject
of malaria, and promising to send us the result of his
observations and experience in that pestilential valley. If
it should turn out that the saving of the life of even one
of the noble men who have taken their lives in their
hands for God and humanity is accomplished, we might
Avell feel that our labors have not been in vain.
Whether it is attributable directly or indirectly to our
stirring of the waters, it is nunc the less a gratifying fact
that a Social Science Club established at Trinity College
has taken up the sul)ject of sanitation. The request of its
Secretary for any literature we might have was, it goes
without saying, gladly honored to the fullest extent of onr
ability, and our satisfaction was still further deepened by
reading in the papers an excellent article on the general
subject by Professor Dowd, the President of the Club. It
is to be hoped that all our institutions will, as years go by,
while not relaxing their efforts for the development of the
'"'"mens sana^'' lay more and more stress on the ''corpore
sajio,^' not only by a judicious encouragement of athletics,
but by giving instruction as to the means of preventing
those ills to which all flesh is heir and before which the
strongest^athlete, when once in their clutches, is liable to
be " downed " forever.
HEALTH CONFERENCE AT WASHINGTON.
On November 6th the Second Health Conference with
the people was held at Washington, Like the first at Salis-
SIXTH BIENNIAL REi'OKT. 37
bun', in September, 1894, it was quite a success. A num-ber
of" papers were read and discussed. One of tliese, on'^Pre-ventive
Medicine," by Dr. J. C. Rodman, was published
in the North Carolina Medical Journal, and the others,
with the exception of Mr. Chase's, on " Sanitary Drainage
and Disposal of Household AVastes," have already appeared
in the Bulletin. This last will he printed i]i our next
issue. The profession of the town and vicinity and the
citizens evinced much interest, as was shown by the fact
that the hall was tilled literally to overflowing, many
being turned away for want of room—an occurrence most
gratifying and unexpected, for, as we were constrained to
say in a notice of the meeting in the Bulletin for Novem-ber
: "We never expected to live to see tiie day when
people in North Carolina would be turned away from a
health meeting for want of room." Those present still
further showed the sincerity of their interest by the ques-tions
thev asked. AVhile the influence of these meetings
does not visibly extend beyond the immediate community
where they are held, they do undoubtedly, from assur-ances
to that eflfect we have received, make a decided
impression within those limits. And if we can biing our
larger towns to a realization of the importance of sound
sanitarv laws well administered, we shall surelv accom-plish
great good. In order to extend more rapidly this
form of work, it might, perhaps, be well to supplement
the conference of the whole Board with the people of the
larger cities and towns by having small committees from
the Board hold what might be properly called Health
Institutes in the smaller places.
national control of sanitary matters.
The following correspondence on this subject betM'een
His Excellency Governor Carr and your Secretary
explains itself. It should, however, be stated tliat an
V
38 NORTH CAROLINA HOARD OF HEALTH.
expression of opinion from tlie Board, in its corporate
capacity being impossible, the views given are merely
those of the .writer:
State of North Carolina, Executive Department,
Raleigh, January 11, 1896.
Dr. Richard H. Lewis, Secretary North Carolina Board of Health,
Raleigh, N. C.
Dear Sir :—I am instructed by the Governor to enclose you a
letter from Joseph F. Edwards, asking for brief expressions on
the advisability of a National Code of Sanitary Laws, etc. The
Governor would be glad if you will give him your views in regard
to this matter.
I have the honor to be, yours very truly,
S. F. Telfair,
Private Secretary.
North Carolina State Board of Health,
Office of the Secretary, 217 N. Wilmington St.,
Raleigh, N. C, January 14, 189G.
His Excellenci/ Governor Carr.
Dear Sir :—In replying to your communication enclosing a
circular letter from Mr. J. F. Edwards, editor of The Annals of
Hygiene, and requesting an expression of my views upon the
question, "Should we have a comprehensive State or National
Code of Sanitary Laws, designed to promote the health of the
people, the observance of which should be made compulsory and
their infringement, made punishable, or should we be satisfied
with efforts to educate the people up to the importance of a vol-untary
observance of sanitary laws V Should we compel or coax
obedience to the laws of health propounded therein?" I beg to
say :
The State can have no higher duty than the protection of the
life and health of its citizens, and it should, therefore, exert all its
powers to promote that end, so that in my opinion it should employ
both compulsion and education—the latter always and every-where,
and the former whenever practicable. In a city with a well-organized
and equipped health bureau, with a strong police force
to back it up, sanitary laws might be fairly enforced in the face
of an adverse public opinion (until the next election), Init in a
sparsely settled rural community, like our State, for the most part,
any law unsupported by public opinion would be a dead letter.
At the same time the very existence of such laws upon the statute
books would have an educational influence, and attempts to
enforce them would stir up the people, excite interest in. and dis-
SIXTH BIENNIAL REPORT. 39
cussion of, the subject, and open their minds to the importance of,
and need for, such laws. The few that we now have relating to
contagious diseases, the contamination of water supplies, etc.,'
have undoubtedlj^ advanced the cause of the public health,
although I have never known of a single person being punished
for the violation of one of them. This is especially true of our
cities and towns.
Our own State Board of Health, having only advisory powers,
has devoted itself to the education of the people by the distribu-tion
of literature of a practical character, and by holding "health
conferences with the people," and I am gratified at the assurance
from various quarters that we have made a distinct and favorable
impression upon the public mind.
I am opposed, personally and oflficially, to the interference of
the General Government in our local affairs, sanitary or other-wise,
except upon request, in times of emergency beyond our
power to meet.
With great respect, I ajn, very truly, yours,
' Richard H. Lewis, M. D.,
Secretary.
VITAL STATISTICS.
Realizing that vital statistics, unless accurate, are prac-tically
worthless, and being convinced from the figures
that the reports sent in from some of onr towns were given
incomplete, I made an eftbrt to secure greater accuracy by
sending the following circular letter to all the health
officers making reports :
North Carolina State Board of Health,
Ob^FiCE OF THE SECRETARY, 217 X. Wilmington St..
Raleigh, N. C, liovember 1, 1801.
Dear Sir :—Vital statistics, to be of any value, must be accurate.
The only vital statistics obtainable in our State are the mortuary
reports from the cities and towns. Some of these reports bear
upon their face evidence of inaccuracy—incompleteness. It is not
just to the towns making full reports and giving the real death-rate
that they should be placed in the same category with those
which do not. I therefore propose, beginning with the December
reports, to print in bold-faced type those reports which are vouched
for by the officials making them, and to call attention to that fact
in a foot-note, so that any one examining the tables may know
which are reliable. If you wish your reports to go into the higher
class do not fail every month to have their accuracy vouched for
by the proper official over his own signature.
40 NORTH CAROLINA BOARD OF nEALTH,
I would respectfully call your attention to thp fact that reliable
mortuary statistics are unattainable in the cities and larger towns
otherwise than by a rigid enforcement of an ordinance forbidding,
under penalty, the burial or removal of a dead body without an
official permit based upon a duly executed death certificate. I
enclose model ordinance and sample blanks, that they may be of
assistance.
Your cordial co-operation in this matter is earnestly desired.
Very truly yours,
Richard H. Lewis, M. D.,
Secretary.
The certificate printed at the bottom of every mortuary
blank that the health officer was required to sign to secure
tlie placing of his town in the list of those regarded as
making reliable reports, was this : " I hereby certify that
this leport gives the whole number of deaths occurring
within the corporate limits during the above month."
Notwithstanding this there are still three or four towns
wiiich, for one reason or another, have not complied with
this requirement, and have in consequence to be enrolled
in the second class. It is to be hoped that this will be
remedied. Owing to the fact that we are so laro;elv a
rural population our only opportunity to obtain vital
statistics is afforded by our towns, and in tliese days of
scientific accuracy mere assertions as to the healthfulness
of our State do not satisfy the intelligent inquirer.
COUNTY BOARDS OF HEALTH.
It is with much regret that I am compelled to report a
discouraging amount of indifierence in a good many
localities on this subject on the part of the members
of the profession. In a number of counties at the reg-ular
biennial meeting, on the first Monday of September
last, a legal quorum could not be obtained. And this,
too, in spite of a circular letter sent with the notice of the
meeting (required of me by the law) to every registered
physician in the State, calling attention to the decision of
SIXTH BIENNIAL REPORT. 41
the Attorney General to the effect that no action on the
pait of the boards wonhl he valid unless a majority of all
those eligible to membersliip participated, and urging upon
the readers the importance of selecting their own sii])er-intendent
of health, and not allowing the privilege to
lapse into the hands of the county commissioners. While
in many instances the commissioners elected superintend-ents,
in at least one instance that has come to my knowl-edge
tliey took advantage of the opportunity to give the
place to the lowest bidder, thereby reducing the salary, —
that had been $250, to '^50, and in others they M'ent
still further, and refused to elect any superintendent at
all. As a consequence of this the number of counties
having superintendents of health l\as been reduced from -
90 to S6. At one time there were 91 counties having
superintendents, but in Graham, before the last election,
the superintendent left the county and no successor has
ever been elected. Camden, Currituck, Hyde, Pamlico
and Washington have never oro;anized countv boards, not-withstanding
repeated efforts on my part to accomplish it.
The chairman of the board of commissioners of Pamlico,
who was the only one replying, stated that they could not
find a physician who would accept the office. Why he
did not say, but proljably because of the sniall pay offered
in that small county. Since September 1, 1895, for differ-ent
causes the county superintendent of health has been
discontinued in Chatham, Gates, Henderson and Jones.
This retrogression, as a fact, is discouraging, but the men-tal
or moral attitude of the authorities towards sanitation
and the proper care of the poor and of the prisoners is yet
more so. There is only one v/ay to renjedy this condition
of things, and that is by educating public opinion. As
mentioned above, the Board is trying to do this itself, as
far as the means at its disposal will allow. But no infiu-enee
can -1)6 brought to bear comparable to that of the
42 ifOBTH CAROLINA BOARD OF HEALTH.
family physician. If the members of the profession Avonld
cordially co-operate with the Board and show to their
patients an active interest in hygiene and impress upon
them the valne and importance of its laws, great things
conld be accomplished. Can we not obtain that help ?
Are not our medical men, admittedly among the best edu-cated
in the country, sufhciently enlightened and humane
to lend their interested aid to so grand a cause as the
wholesale saving of life? We can but believe that the
cause of this indifference on the part of so many—not all,
by any means—is simply tlioughtlessness—they have never
considered the (juestion seriously. We sincerely hope for
better things from them. While these discouragements
and others press upon us there is no question that the
public mind has been appreciably awakened, and that the
people of the State, as a w^hole, are much more interested
in, and alive to the importance of, preventive medicine
than they were twelve months ago. AVe have not been
standing still.
On motion the conjoint session adjourned.
GEORGE GILLETT THOMAS, M. D.,
President.
Richard H. Lewis, M. D.,
Secretary.
SIXTH BIENNIAL REPORT. 43
REPORT ON THE SANITARY CONDITION OF
THE STATE AND OTHER INSTITUTIONS.
Owing to the exhaustion of the appropriation made by
the General Assembly for the work of the Board, the
usual inspection of the convict camps could not be made.
All the State institutions proper were, however, visited
and inspected, as appears from the particular reports
below :
NORTH CAROLIN^A INSAiSE ASYLUM, INSTITUTION FOR
THE DEAF, DUMB AND THE BLIND, PENITENTIARY,
STATE CAPITOL.
Dr. George G. Thomas, President of the State Board of Healtli.
Sir :—The Committee of the Board of Health appointed to make
a sanitary ins^pection of the North Carolina Insane Asylum, the
Institution for the Deaf, Dumb and the Blind, the Penitentiary
and the State Capitol, begs leave to submit the following report :
NORTH CAROLINA INSANE ASYLUM.
Y'our Committee was received with every courtesy by Dr.
Faison in the absence of the Superintendent, and was shown
through every ward in the Asylum. The wards upon the male
side Avere too much crowded, but the additional wing in process of
erection will relieve the present wards of this undue strain. The
sanitary condition of these wards was otherwise good. The
cleanliness, neatness and good ventilation were worthy of note.
The water closets flushed Avell and seeuipd to be well trapped.
Very little odor was noticeable from them . The same was true of
the female wards. The arrangements for feeding the patients
were neat and wholesome.
The Asylum is excellently located for drainage purposes, and
there is no reason why this should not be perfect. The water
supply is, however, a point which should receive the careful
attention of the authorities of the Asylum. The boring of a deep
well which is now in progress may remedy all defects along this
line. When completed the water of this well should be carefully
examined and its quality determined. The stables, dairy and pig-styes
were also visited and found in good condition, and so not at
all a source of danger to the Asylum.
INSTITUTION FOR THE BLIND—WHITE.
Everj" opportunity for any inspection of the buildings was
afforded vour Committee through the kind attention of the Prin
44 NORTH CAROLINA BOARD OF HEALTH.
cipal, Mr. Ray. The ventilating arrangements for one of the large
sleeping rooms for the boys seemed imperfect. It would be diffi-cult
to admit the needed fresh air. where so many were sleeping,
without serious drafts, in the present arrangements. The water
closet provided for the boys is poorly fitted up, dark and not well
ventilated. The boarding up of some of the sinks and washstands
is also objectionable. The absence of the proper storage rooms
for trunks, &c., is a serious disadvantage with which the Superin-tendent
has to labor, necessitating an overcrowding of the sleep-ing
quarters.
The sewerage system is connected with that of the city. The
water supply is also in part the city water. Fur food purposes the
main reliance seems to be placed upon the well immediately in the
rear of the building. ]^fo examination has been made of this water
in the past two years, and the suggestion was made by your Com-mittee
that it be carefully examined and periodically watched in
the future, as its location makes it liable to contamination at any
time. There is a large cistern already constructed. This might
be thoroughly cleansed and fresh water caught from the roofs and
used in preference to the present supply.
INSTITUTION FOR THE DEAF, DUMB AND THE BLIND—COLORED.
The interior arrangements of this building, sleeping rooms, hos-pital
wards, bath-rooms, closets, &c., seemed to be verj^ good.
Storage room is, however, needed, and imijroved furnishings for
the outside closets for the boys. The large well, from which much
of the water for drinking purposes is taken, is, from its depth, loca"
tion and proximity to the drains, not above suspicion. It has been
recently cleaned out, but its purity has not been tested in some
years and should be carefully looked into.
THE PENITENTIARY.
Your committee went over the penitentiary buildings under the
.guidance of Capt. Fleming. Comparatively few convicts were
under his charge at the time of our visit. The buildings are in
good order and the health of the convicts seems to be well cared
for. We think it would be wise to substitute a complete system
of water closets, with good sewerage connections, for the present
combination of water and earth-closets, and also to continue the
exit pipe from the drain at least as far as the bed of the creek and
not let it empty just outside the wall, as at present. The water
used is partially derived from wells. These should be carefully
watched and examined. It would seem to be safer to ,use the
water from the large and excellent spring just below the walls.
SIXTH BIENNIAL KEPOKT. 45
THE STATE CAPITOL.
The plumbing and sanitary arrangements, as far as could be
seen, seemed to be good. The building is connected with the city-water
and sewerage system. The water from the well in the Cap-itol
Square is used by some in preference to the city water.
Respectfully,
S. Westray Battle.
F. P. Venable.
STATE U]S^IVERSITY, COLLEGE OF AGrRICULTURE AND
THE MECHANIC ARTS.
November 6, 1896.
Dr. George G. Thomas, President North Carolina Board of Health.
Dear Sir :—Following we give a report of our visits to the pub-lic
institutions assigned us by the Board.
THE STATE UNIVERSITY.
AVe find the general sanitary condition satisfactory. A good
number of fixtures of an improved type have been provided, and
the sewerage is discharged into a small branch at a proper distance
from the buildings.
The water supply, which comes from a large well on the campus,
appears to be falling ofl' in quantity, and at the time of our visit
the supply was so limited that no use could be made of the baths,
and the urinals had very irregular flushing. For the latter fixt-ures
a plentiful supply of .water is very essential, and we consider
the question of increasing the present supply a vital one.
The present shortness of supply is undoubtedly caused, in a
large measure, by the use of several hundred gallons per day by
the elefetric light engines, but be that as it may, the necessity of
more water is so evident as to require no argument. An abundant
supply can be had from either of two neighboring creeks at a dis-tance
of a mile or more from the present center of use.
It is probable that the present supply can be inci-eased sufH-ciently
to answer the purpose for awhile longer by sinking one or
two more wells at a distance from the present one, but we are of
the opinion that the natui-ally increasing use will eventually be-come
so large that the supply could not be maintained by wells
having such a comparatively small area tributarj^ to them as the
ones under consideration.
Should a supply be obtained from one of tlie creeks before
mentioned we should consider it advisable to provide a plant that
would be able to supply other consumers as Avell, which would
materially aid in meeting the operating expenses.
We ai"e pleased to note the installation of a well arranged elec-tric
lighting ijlant, which lights the grounds and buildings very
efficiently. Also the opening of a "'Commons'' boarding hall in
46 NORTH CAROLINA BOARD OF HEALTH.
the gynasium building. We desire to testify to the particular
cleanliness and attractiveness of everything connected with this
establishment, and from personal experience can heartily com-mend
the dietary both in quality and quantity.
THE COLLEGE OF AGRICULTURE AND MECHANIC ARTS.
The conditions at this institution are practically the same as
when visited by a representative of the Board (Mr. Chase) some
two years ago and set forth in his report.
The increased attendance and additional buildings erected
emphasize the desirability and necessity of an improvement in the
sanitary arrangements, certainly so far as convenience and com-fort
are concerned. In these days baths and water closets have
come to be regarded as necessary adjuncts of our civilization, espe-cially
when there is any large aggregation of human beings, and
we consider that in this specific instance no reasonable expense
should be permitted to debar their installation.
We are aware that the question of sewage disposal has been
regarded as a serious if not insuperable obstacle in the way of
making a general use of sanitary fixtures. We would by no means
advise the discharge of the crude sewage into the small branch
that passes through the College grounds, even if there were no
prospect of objections being raised by abuttors on the stream
further down.
AVe fully believe that the limited amount of sewage to be pro-vided
for can be readily disposed of by surface irrigation on the
lowest portion of the College tract, near the railroad, and that such
disposal will be no more objectionable or detrimental to health
than the existing privies and stables.
We do not feel ourselves called upon to go into details regard-ing
the manner of carrying out such a work, that being the prov-ince
of an engineer, and the nature and gravity of the work would
necessarily require the employment of one. Suffice it to say that
an object lesson can be had at the State Hospital for the Insane at
Columbia, S. C, the sewage of that institution being disposed
of in the way above mentioned.
If no change is made in the existing methods we believe that a
better type of privy could be provided, and they could certainly
be kept in better condition.
The supply of water has lately been increased by means of sev-eral
driven wells, which yield a fair supply of satisfactory quality.
While we are not prepared to say that there is any danger of their
becoming contaminated by any pollution of the surface of the
ground immediately above them, we do not consider that it is
quite in accordance with sanitary teachings to make use of the
SIXTH BIENNIAL KEPORT. 47
ground about these Avells for a cow yard. There is a certain sen-tinient
about such matters that it is Avell to bear in mind, and it
should not be forgotten that the youth who are educated at this
institution are likely to be no small factor in assisting to raise the
standard of refinement and civilization throughovit the State.
Respectfully submitted,
Richard H. Lewis,
John C. Chase.
THE STATE NORMAL AND INDUSTRIAL SCHOOL.
Dr. George G. Thomas, President State Board of Health, Wil-mington,
N. C.
Dear Sir :—In accordance with your instructions of May 14th,
we have visited the State Normal School at Greensboro and con-ferred
with President Melver in regard to the best method of
sewage disposal for that institution.
While excreta and general household wastes are occasionally
disposed of by cremation in such institutions, we do not deem
that method of disposal worthy of consideration in the present
instance.
Water carriage is universally admitted to be the best method of
removing household wastes and the method of ultimate disposal
will depend upon local conditions.
In this particular instance the construction of a pipe sewer some
two thousand feet in length would discharge the sewage into a
small branch where the danger of its becoming a nuisance would
be improbable, at least until the quantity is largely in excess of
what it is likely to be in the near future.
As there seems to have been an idea prevailing that this method
of disposal might contaminate the city water supply it is proper
to say that such fears are unfounded, as the branch into which
the sewage will be discharged joins the stream on which the city
water works are located below the point where the supply is
taken.
We recommend that the branches from the various buildings
should be six inches in diameter and the main sewer eight inches ;
that the minimum grade of the former should be one foot fall in
fifty feet, and of the latter one in eighty. Also that an automatic
flush-tank be put in, to be operated by the waste water from the
laundry, and that provision be made to turn a certain amount of
roof water into tlie drains running from the other buildings.
The best quality of salt-glazed sewer pipe should be used. It
should be laid true to line and grade, and all changes in direction,
48 NOKTir CAROLINA BOARD OF HEALTH.
either lateral or vertical, should be made at angles eased off by
slight curves, which are made acces^sible by luanholes. By avoid-ing
the use of long curves and having the sewer straight between
the manholes any obstruction can be easily located and removed
Avith the least possible difficulty. Additional manholes should be
provided, so that the maximum distance between any two should
not exceed four hundred feet.
We consider that the magnitude and importance of this work
demand the services of an engineer skilled in such Avork. We
believe that definite data to prospective bidders on the projected
work will reduce the cost to an extent that will fully justify the
additional outlay and at the same time the future integritj'of the
work will be assured.
The plans for the new infirmary were submitted for our inspec-tion.
The proposed building seems to be well adapted to the
purpose for which it is designed and the only suggestion we have
to offer is, that the bath tubs should be in separate rooms from
the water closets.
Respectfully submitted,
John C. Chase.
W. P. Beall, M. D.
Wilmington, May 20, 1896.
December 1, 1896.
THE STATE NORMAL AND INDUSTRIAL SCHOOL AND
THE AGRICULTURAL AND MECHANICAL COLLEGE FOR
THE COLORED RACE.
Dr. Geo. G. Thomas, President of North Carolina Board of Health.
Dear Sir :—We have visited the State Normal School and the
Agricultural and Mechanical College at Greensboro, as instructed
by the Board, and submit the following report :
At the first-named institution we find the sanitary condition
highly satisfactory. Since last visited by a representative of the
Board a sewer has been constructed which discharges the house-hold
wastes into a small branch at a point some two thousand
feet from the buildings. This sewer was laid in substantial
accordance with the advice given by the Engineer of the Board
on May 30, 1895, and the work appears to have been done in a
first-class manner. We are pleased to learn that the advice of the
Board was followed in employing an engineer to design and super-intend
the construction of the work. Two flush-tanks were put
in as recommended, but no provision was made to provide a regu-lar
and sufficient supply of water for their operation and the pres-ent
condition of the sewer shows the effect of the omission. AVe
therefore recommend that the flush-tanks he supplied from the
SIXTH BIENNIAL REPORT. 49
water works system of the institution, such supply to be so gauged
that the tanks will discharge every 24 or 36 hours. We also ad-vise
that a small covered catch basin be built at the sewer outlet,
designed to retain the solid portion of the sewage, which could be
removed and buried from time to time. At the present time this
matter is deposited along the sides of the branch and is rather
unsightly, although its distance from dwellings would preclude
the idea of its being a nuisance, for the present at least. We are
inclined to believe, however, that the time will come when it will
be found advisable to dispose of the sewage by surface irrigation
and an admirable chance can be had at a short distance from the
present outfall.
The water supply of the institution for general purposes comes
from the city water works. At the time of our visit the supply
was shut off on account of repairs to the street main so none of the
fixtures could be seen in operation, but the general appearance
and arrangement of the plumbing was satisfactory.
Since our last visit a well arranged infirmary has been built,
ane tlie only adverse criticism we have to offer is that our sugges-tion
was not followed in regard to placing the water closets and
bath tubs in separate rooms. An additional isolated water closet
can be very easily provided, hov.ever.
At the Agricultural and Mechanical College we find that the
water supply in the kitchen comes from the city watersupply, but
no other fixtures are in use. The only sanitary conveniences are
the ordinary box type of privies, which appear to be kept in good
condition.
We consider it highly advisable that this institution should be
equipped with baths and water closets, not only as a means of
comfort and also conducive to healtli, but on account of the ele-vating
and refining influences that will naturally result.
The sewage of the institution can be very easily disposed of by
surface irrigation. The general condition of the grounds and
buildings metit commendation.
By invitation of Dr. W. J. Richardson, County Superintendent
of Health, we visited the jail in Greensboro. The general condi-tion
has recently been somewhat improved by the introduction of
water closets, but tliere is no gainsaying the fact that a new jail
of modern construction is imperatively needed. The present
structure is a disgrace to the intelligent community which toler-ates
it, and the fact is so ^elf-evident to any one who may visit it
that we do not feel called upon to go into particulars.
In this connection we desire to express our conviction that there
should be some restrictions against the overcrowding of jails. In
some cases this is caused by using them as places of temporary
4
50 NORTH CAROLINA BOARD OF HEALTH.
detention of Federal prisoners awaiting trial, and the rapacity of
the jailer for the resulting- profits of boarding the prisoners appears
to be the only measure of the capacity of the jail.
Respectfully submitted,
John C. Chase.
W. P. Beall.
school for the deaf and dumb.
Board of Directors, School for the Deaf and Dumb,
Morganton, N. C.
GtENTlemen :—The undersigned, a committee appointed by the
State Board of Health to make a sanitary inspection of your insti-tution,
beg leave to report as follows :
Desiring to see the institution in its everyday state, we purposely
did not not notify the Superintendent of the time of our proposed
visit. We are very glad to be able to state that we found it in
excellent condition. We noted one or two small leaks about the
water-closets. We also commented on the wooden block under a
bath-tub on the girls' side resting in the channel for the waste
water from the shower baths. The position of the tub should be
changed, or a support of some material impervious to water sub-stituted
for the block of wood.
In a part of the basement and in the bottom of one of the ven-tilating
shafts, we observed an accumulation of litter, which, while
not positively dangerous to health, perhaps, was offensive to the
sanitary sense.
We called the attention of your wide-awake Superintendent to
all these matters, and he informed us that our suggestions would
be promptly carried out.
We desire to make our acknowledgements to Superintendent
Goodwin for his courteous attentions and for his active assistance
in making the insj^ection.
Very respectfnlly yours,
George Gillett Thomas,
Richard H. Lewis,
Committee.
the state hospital at morganton.
To the Board of Directors of the State Hospital,
Gentlemen :—Under the instruction of the State Board of
Health the undersigned visited and inspected the Hospital at
Morganton, with special reference to its sanitary condition. It
gives us great pleasure to report to the body which we represent
and to yours the excellent state of affairs instituted and maintained
under vour direction for the well-being of the inmates. The
SIXTH BIENNIAL REPORT. 51
plumbing was everywhere of the best order, and the ciosets were
generally odorless. The onlj- exception existed in the wards
occupied by the more violent patients, and the condition in these
was only noticeable by comparison with the general cleanliness
that existed in every department.
The appointments of every kind in the Hospital and about the
property seemed to us to deserve only the most favorable com-ment,
unless we except the provisions for protecting the gang-wells
in the rear of the barn from the washing of the buildings,
which appears to us to be worthy of your attention.
We beg leave to commend the training school for nurses that
has been organized by the permission of your Board. It is a most
progressive measure and will redound to the good of the Hospital,
and in time measurably supply the want of trained persons in the
sick room, when these young persons have served their appointed
time under the Hospital management.
We trust that the effort to equip a bacteriological laboratory at
the Hospital will find favor with your Board. A small beginning
has been made, and we submit respectfully that it will, if projierly
enlarged and put under trained supervision, be of great service to
the institution and State at large, especially the Board of Health.
We owe to your Superintendent and his courteous and able
assistants many obligations for the aid they willingly rendered us
in the performance of our duty, and we esteem it a matter of con-gratulation
that your Board has so wisely chosen the executive
oflScers of the institution you control.
Very respectfully yours,
Geo. Gillett Thomas,
Rich'd H. Lewis,
Committee.
THE EASTERN HOSPITAL AT GOLDSBORO.
To the Board of Directors of the Eastern Hospital.
Gentlemen :—Under the instruction of the Board of Health of
North Carolina, I visited the instituiion Avhich is under your care.
The courteous and capable Superintendent showed me the build-ings
and the proi^erty immediately around them.
The well-directed improvements of the institution were every-where
manifest, and the sanitary condition of the premises, to
which I was directed to give especial attention, was excellent.
The property gave evidence of skillful management and unre-mitting
care. The plumbing was all in good condition and the
new wards you have erected were of the best modern pattern.
The wards were clean and the patients were comfortably provided
for and not crowded.
52 NORTH CAROLINA BOARD OF HEALTH.
The scheme of the Superintendent to add to his staff a female
physician of good standing will commend itself to your judgment.
I desire to tender my thanks to the Superintendent, Dr. Miller,
for his pleasant attention and assistance in ])roperly m^aking the
inspection. Very respectfully yours,
Geo. GriLLETT Thomas.
OXFORD orphan ASYLUM.
The water supi^ly comes from some deep-seated springs on the
grounds, at a distance of several hundred feet from the main
building and is pumped by steam to a metal tank in the attic of
the girls' building. The wat^^r is apparently of good quality and
there appears to be no probable chance of contamination, as
proper precautions have been taken to prevent pollution.
The girls' building is supplied with baths and water closets, and
the new buildings being erected for the boys will have like con-veniences.
The present boys' building is not a credit to the
institution, and it is gratifying to know that ere long it will be
abandoned for the new buildings, which are exceedingly well
adapted to the purposes for which they are designed. The
plumViing in the girls' building is of a generally satisfactory char-acter,
and the same can be said of the plans of that which is pro-jjosed
for the new buildings.
A new brick building to contain the kitchen and dining-rooms
is nearly completed. It is admirably an-anged for its prospective
uses and will be a great improvement over the present arrange-ments.
Several additional buildings and other improvements are
in contemplation, and 1 am pleased to know that comprehensive
location plans were made and lines for water and sewer pipes laid
down before any of the work was undertaken. This is so at
variance with the general custom in our State that it deserves
mention and commendation.
The sewage is discharged through a well-laid pipe into a ditch
with a never-failing stream of water several hundred feet from the
buildings. I am of the opinion that in due time this method of
disposal will have to be abandoned, but there is an excellent op-portunity
to adopt a scheme of surface irrigation, and as the
Superintendent is in accord with this view and has given the
matter some study, it can be safely left in his hands.
The surface drainage about the buildings will be excellent after
the improvements now in progress are completed, and I see no
reason why this institution should not retain its present high rank
for healthfulness, which, it is believed, is not excelled in the State,
taking everything into consideration.
John C. Chase.
SIXTH BIENNIAL REPORT. 53
INSTITUTIONS OTHER THAN STATE.
DAVIDSON COLLEGE.
Dr. George Q. Thomas, President N. C. Board of Health.
Dear Sir :—I submit the following report of the visit of inspec-tion
and advice made, by request, in accordance with the instruc-tions
of the Board, to
DAVIDSON COLLEGE,
for the purpose of advising in regard to the best method of sewage
disposal for a new building erected for the medical department.
The general configuration of the grounds and the limited amount
of sewage to be provided for indicated that it could be satisfac-torily
disposed of by discharging it into a small branch several
hundred feet from the building.
In the course of time it would perhap.s be advisable to make the
point of discharge farther down the valley, or if it should seem
best it could be used advantageously in surface irrigation near the
point first mentioned.
The sewage of the whole institution would most likely be dis-charged
in this direction when sanitary conveniences become
available.
The question of obtaining a water supply seems to be para-mount
at this time and it is not at all clear from whence it can be
derived.
It may not be out of place to reiterate the general instructions
given in regard to the construction of the proposed sewer. The
grade it would apparently have makes a six inch pipe ample for
the purpose. It should be of the best quality of salt-glazed pipe
and laid true to line and grade. Any change in direction, either
lateral or horizontal, should be made at angles connected by
slight curves. These curves should be made in manholes, and by
having the sewer perfectly straight between them any obstruction
can be easily located and removed. Intermediate manholes
should be put in whenever necessary, in order that the maximum
distance between two adjacent ones shall Lot exceed 300 to 350 feet.
They may be used seldom, if ever, but when they are needed their
absence will be found to be a serious inconvenience.
The institution is so advantageously located that it precludes
any uneasiness in regard to surface drainage.
Respectfully submitted,
JOHN C. CHASE.
54 NORTH CAROLINA BOARD OF HEALTH.
JOHNSTON COUNTY JAIL.
Selma, N. C, April 17, 1886.
Geo. G. Thomas, M. D., President North Carolina Board of Health,
Wilmington, N. C.
My Dear Sir :—The Board of County Commissioners of John-ston
county want to move their jail, and I would like for yovi to
appoint a committee to look out for the health of the prisoners
and make suggestions as to the sanitary conditions of the jail.
Please notify me and I will meet the committee. Let them meet
in Smithfield, Johnston county, any time between now and May
1st. Please let me hear from you at your earliest convenience.
Yours very truly,
R. J. ZS'OBLE,
Superintendent of Health of Johnston County.
Raleigh, April 28, 1896.
The Board of County Commissioners, Johnston County, N. C.
Gentlemen :—The undersigned, a committee from the State
Board of Health, at the request of your Superintendent of Health,
Dr. R. J. Noble, visited your county town of Smithfield on Mon-day,
27th inst., for the purpose of inspecting the present jail and
the site on the riverside to which it is proposed to remove the
same, and for giving an opinion from a sanitary point of view
upon the advisability of such removal. We beg leave to respect-fully
report as follows :
In company with Dr. Noble and Sheriff Elliugton, we carefully
inspected the jail. We aie much gratitied to be ^ble to say that
we found it in an excellent sanitary condition—sweet and clean,
in spite of the antiquated method of fecal removal by buckets
still in use, and a credit to the management of those in charge.
Such a desirable state of affairs under similar circumstances, we
fear is not common, and we cordially commend the enterprise and
humanity of your honorable Board in proposing to put in sewer-age
and thereby insure, as far as possible, a continuance of the
same cleanliness, in that one respect at least, in spite of unfavor-able
changes of administration that are almost sure to come as
time passes. But Ave think a mistake has been made in substitut-ing
mattresses on the floor for the swinging hammocks. They are
un.'anitary in more than one aspect, and we would respectfully
suggest a return to the hammock system, notwithstanding their
occasional destruction by the prisoners. The difference in cost
would be trifling and they are much prefei-able. We also think
your system of heating could be improved, and at small expense,
in the manner set forth below.
SIXTH BIENNIAL REPORT. 55
The site suggested for the new jail we exauiined carefully, and we
are satisfied that it is a much better one than that now occupied.
While nearer the river, we could find no reasonable ground for
thinking the danger from malaria any greater, certainly if a
sufficient supply of cistern water be provided for the inmates to
drink. The cost of a cistern made by utilizing a part of the walls
of the basement would be trifling. While a tin-roof would answer,
slate would be better and cost only S2 per square more than the
best tin, proving doubtless more economical in the long run. We
send you pamphlet on " Drinking Water in Its Relation to Mala-rial
Diseases,'' in which you will find i^laris and instructions for
building cisterns.
The chief advantage of the new location would be in the short
sewer pipe, with rapid fall, located not very far below the surface
of the ground. The long sewer, from the present location, with its
gradual fall, could not be satisfactorily flushed, owing to the scanty
water supply afforded by a 500 gallon tank filled by a hand-force
pump, and it would eventually become clogged. To dig up a sewer
so deeply buried as that would have to be to obtain the proper
fall, in order to find and clear away the obstruction, would be a
very expensive piece of work, and one that would almost surely
recur. The short, steep sewer could be scoured from end to end
daily at an outlay of a comparatively small aiU'iunt of water, and
should any accident happen to it in its course it could be taken up
entirelj^ and relaid, if necessary, at a very small cost.
We would respectfully deprecate the plan of merely reproducing
the old jail in the new. It seems to us that it would be unworthy
of a county that has the present standing and promising outlook
possessed by Johnston. In our opinion you would never I'egret
the erection of a more modern structure, in which is provided a
separate room for a sick prisoner (which could be utilized also when
the jail happened to be overcrowded), and quarters for the jailer
—
certainly for a guard—who would then always be within call so as
to promptly summon aid in case of sudden illness in the night, to
say nothing of the effect of such proximity upon the safety and
behavior of the prisoners. It is just such little finishing touches
as these which show the civilization of a community, and which
not only favorably impress the stranger, but elevate the commu-nity
itself.
Should a new jail be erected, we would respectfully suggest a
change in the method of heating nnd ventilating it. We would
recommend that the chimney be bnilt with two fines, having a
very thin partition between them—one for the smoke and the
other, extending to the floor with a register at the bottom, for
taking out the foul air. A jacketed stove with an inlet pipe pass-
56 NOKTH CAROLINA BOARD OF HEALTH.
ing through the wall should be provided. The fresh, pure air
from outside, haA'ing been warmed as it passed through the nar-row
space between the stove and jacket, would rise to the top and
force out through the ventilating flue the coldest and foulest air
in the room, which always lies next the floor. The air in this flue,
being more or less warmed thi-ough the thin partition by the hot
smoke, would rise and, therefore, draw, making a pull upon the
foul air in addition to the push given it by the warm, fresh air
constantly pouring in. The adoption of this method would fur-nish
ideal heating and ventilation at a merely nominal cost.
Expressing our appreciation of the courtesies shown us, we are
Very respectfully yours,
Geo. GriLLETT Thomas,
Rich'd H. Lewis,
Committee.
MUNICIPAL WATER SUPPLIES.
At the annual meeting of the Board at Winston the
subject of tlie municipal water supplies of the State was
discussed. Wliile the Board realized its inability to
accomplish much in the wa}- of assuring the purity of
such waters owing to the total lack of mandatory powers in
the law covering it and the insulHcienc}' of the appropri-ation
to justify more than the most cursory investigation, it
feels that something should be done. It was therefore
decided, as appears in the report of the proceedings of the
meeting printed al)ove, to have a single exaniination made
of each public water supply, that being as much as it could
hope to pay for. This was done for the purpose of inform-ing
tlie water companies that some one was overlooking
them, and with the inten ion, if a supply should be found
bad and the company refused after having its attention
called to the fact to make at least a reasonable effort to
remedy the trouble, to bring the pressure of public opin-ion
to bear upon it bv havino- the results of the investiija-tion,
setting forth the character of the water, published in
the local newspapers.
In compliance with the order of the Board the Secre-tary
mailed to the respective health othcers of the cities
SIXTH BIENNIAL REPOKT. 57
and towns havincr public water gnpplies, viz : Asheville,
Charlotte, Concord, Durham, Fas'etteville, Goldsboro,
Greensboro, HendersoTi, Newbern, Raleigh, Salem, Salis-bury,
Wilmington, Wilson, and Winston, the following
letter :
North Carolina Board of Health,
Raleigh, N. C, August 15, 1896.
My Dear Doctor :—The Board has ordered, for its own in-formation,
a bacteriological examination made of the public water
supplies of all our cities having them. It wishes the sample taken
by a medical health officer from a faucet from which drinking
water is drawn, and packed and shipped in exact accordance Avith
the directions on the back of the permit herewith enclosed. Ac-companying
this will be a sterilized bottle.
Please do not fail to take the sample, and pack iinmeiliately
with an abundance of ice and sawdust, as near the departure of
the train as possible so as to lose no time in transit.
As the Board proposes to bear all the expense you will not pre-pay
express charges. You can also i^end bill to me for cost of
packing. Your prompt and careful attention to this matter
would oblige, Youri< very truly,
RICH'D H. LEWIS, Secretary.
Upon the receipt of the rej)ort from the bacteriologists,
this letter was mailed to the health officers of the cities
having infected water:
North Carolina Board of Health,
Office of the Secretary,
Raleigh, N. C, October G, 1896.
Dear Doctor :—I learn from the duplicate report sent me by
Dr. (Anderson or Pate, as the case was) of the bacteriological ex-amination
recently made by him, at the request of the Board, of
the public water supply of your city, that the water is infected
with intestinal bacilli. It is, of course, unnecessary for me to call
your attention to the danger to the people of your community of
an infection of their water supply of such a character, or to the
importance of immediate action on j'our part in the premises. I
wou-ld thank you to let me know at once what steps you have
taken in the matter, and also what action those in control of your
water supply propose to take. As the Board is to meet at Char-lotte
on the 15th inst., a reply before Wednesday, the 14th, when
I must leave for the meeting, would be greatly appreciated.
Very truly yours,
RICH'D H. LEWIS, M. D., Secretary.
5S NORTH CAROLINA BOARD OF HEALTH.
To this letter only one reply, from Raleigh, was re-ceived.
At the meeting of the Board during the Health Con-ference
with the people in Charlotte on October 15th, two
months after this letter was mailed, the Secretary stated
that he had re'ieived from the bacteriologists employed by
the Board, Drs. Albert Anderson, of "Wilson, and W. T.
Pate, of Gibson Station, reports on all the supplies except
those of Charlotte and Fayetteville, from which he had
np to that time been unable to obtain satisfactory samples.
From the reports received (which see below) the waters of
Asheville, Concord, Greensboro, Henderson and Raleigh
were shown to be infected with intestinal bacilli, and those
of Goldsboro, Newborn and Winston suspicious, while the
remainder were more or less good.
As the result of this showing the Secretary, as appears
in the proceedings of the Board, " was instructed to have
made immediately another bacteriological and a chemical
examination of all the infected and suspicious waters ; and
he was further ordered in those cases where the water was
shown to be still bad to notify the Superintendent of
Health, the Mayor and the manager of the water w
—
as you propose. The address of the latter is Gibson Station, and
you shovild write to him for a sterilized bottle. The reason that
nothing has been heard from him by Dr. Wilder in regard to the
samples sent him is that neither was taken according to instruc-tions.
After waiting a month, or longer, he sent a sample from a
well, although he was requested to send a sample drawn from a
faucet of the public ivater supply, and later he sent a sample in
his own bottle (properly sterilized, doubtless, Ijut we can't take
any chances) drawn immediately from the filter—again not what
we asked for. To be sure of having it right the Board requested
Dr. Pate to take the sample himself. This he did " from faucet
at the Buford Hotel October 10, 4:40 A. M., and placed it in culture
media the same morning at 11:30"—to use his own words. When
I saw his report of 7,500 bacteria to the cubic centimetre the
explanation you suggest—that the filtered water had not gotten
into that main—occurred to me.
I cannot understand Pi'of. Leeds' statement that the water he
examined contained "no bacteria'"—he must have meant no
pathogenic bacteria. « * *
In fairness to your water I think it would be well to suggest to
the health officer the importance of packing the samj^le in an
abundance of lee and saw-dust in order to prevent the growth of
the bacteria until it can reach Dr. Pate. Dr. Pate authorized me
to say to the managers of water companies that he would make
quantitative analysis for them for $10. I enclose blank which gives
explicit directions which must be carried out to the letter, or the
analysis will be invalidated. Please let me have copy of all the
analyses you have made, and oblige,
Yours very truly,
RICHARD H. LEWIS, Secretary.
6-t NORTH CAROLINA BOARD OF HEALTH.
Charlotte, November 19, 1896.
Dr. li. H. Leiois.
m
T enclose Dr. Leed's analysis. * * * *
I wrote Dr. Pate a few days since asking him to send me two
bottles, as I wish to have specimens examined from the filter and
also from the tap at the Buford, so that I can tell whether the
trouble, should it still exist, is in the pipes. Of course I under-stand
these are separate analyses.
Now as to examinations : I found when we took charge of
the plant two, which I can't lay my hand upon, made from, I think,
Johns-Hopkins, certainly some Baltimore chemist, Avhich were
entirely satisfactory. These Avere chemical examinations. Since
that time Professor Leeds and Dr. Herbert Battle have examined
it for us. Satisfactory, except about two months ago Dr. Battle
found the free ammonia ran too high. This I knew was due to
the cause I mentioned to you, i. e. that owing to excessive drouth
and waste of water, the reservoirs were nearly empty, and when
we did have a heavy rain we had to fill up with the rain-water
which ran over the fields and meadows—was about as milddy as
possible. Since then we have gotten on a large supply, and of
course that cannot occur again, and if it becomes necessary while
it is costly I will abandon present supply and use that from Bear
Creek.
Will write you as soon as I have anything further to communi-cate.
I feel that I am giving you a good deal of trouble and cer-tainly
appreciate your kindness.
Yours truly,
R. J. BREVARD.
I did not mention that samples have been sent by health officer.
dr. leed's report.
Stevens' Institute of Technology,
HOBOKEN, N. J., November 17, 1896.
Sample of filtered water fr( m Charlotte, N. C.
The sample exhibited no bacteria after three days' culture with
gelatine peptone solution, and may be regarded as practically free
from bacteria. Very respectfully,
ALBERT R. LEEDS,
Professor of Chemistry, Stevens' Institute.
SIXTH BIENNIAL REPORT. 65
(Jharlottk, N. C, November ;^(J, 1890.
T)r. E. H. Lewis.
My Dear Sir:—I enclose you bacteriological examination made
by Professor Wm. Royal Stokes, of the Johns Hopkins Hospital,
who is also bacteriologist for the city of Baltimore, and, I believe,
of the State of Maryland. You will observe that it is addressed to
Professor Penniman, of the firm (if I may call it so) of Penniman &
Boone, chemists. They are the State chemists, and I understand
are men of very high standing. I requested them to examine it
^chemically and submit same to the best bacteriologist for exatiii-nation.
1 may mention that they made the chemical examina-tion.
Don't believe you lay mue'. stress upon chemical examina-tions,
so will not copy it, but they made this comment : " This
water shows no sign of contamination upon chemical or bacterio-logical
examination. It is admirably suited for manufacturing
and domestic purposes." Yours truly,
R. J. BREVARD.
I shall get Pate to re-examine as soon as be sends the bottle, which
he says he will do as soon as he gets a new instrument.
DR. STOKES' REPORT.
Health Department,
City Hall Annex,
Gay Street between Lexington and Saratoga Sts.,
Baltimore, Md.
Prof. Penniman.
Dear Sir :—The sample you sent me was clear, showing no
sediment upon standing twenty-four hours and no odor.
Microscopic sediment : No animaleulae, plants, algae. Germs :
jjrotocoecus spiralis.
These luinute vegetable organisms are present in pure water,
and tlie absence of animaleulae suggests this condition also.
Colonies per cubic centimeter, 146.
This is very low as compared to many of our municipal water
supplies—Philadelphia often showing 1;"),000.
Fifty centimeters of water was examined by makers of growth
in bouillon, plating, and then inoculation of fermentation tubes of
glucose, lactose and saccharose, 1 per cent, bouillon.
No gas production took place after twenty-four hours, showing
that the colon bacillus, bacillus coli communis, the normal inhab-itant
of the intestine, was not pi-esent in this amount of water.
The examination shows that the sample of water sent is pure
5
56 XOKTH CAROLINA BOARD OF HEALTH.
bacteriologically ; in fact, remarkably so. It is not customary to
base absolute conclusions upon a single examination of an entire
water supply, and a second examination would enable me to
gauge more correctly of the exact condition of the water. This
should be made after an interval of several weeks.
Very respectfully yours,
WM. ROYAL STOKES.
Ill a letter from Dr. Pate, dated Deceitiber 28, 1896, he
says :
•' I have examined two samples from the Charlotte
supply, both remarkable for their bacteriological purity."
Since this investigation was made the Charlotte water
works have been purchased by the city.
CONCORD.
RKPORT OF BACTERIOLOGICAL EXAMINATION.
Gibson Station. N. C. October 12, 1896.
To Dr. Young, Concord.
The sample collected by you from the public water supply of
Concord, September 25, contains 600 bacteria to the cubic centime-tre
of water. It contains both proteus aad intestinal baccilli. In
point of numbers the water is fair, but in quality of bacteria had.
The indications are that if you will clean up your water shed,
and stop all sources of fecal eontautii nation, you would have fine
drinking water.
Yours truly.
Duplicate. W. T. PATE.
Gibson Station, N. C, December 1, 1896.
Dr. Young, Concord.
The sample of water sent by you from the public water supply
of Concord, November 10, contains 620 bacteria to the cubic
centimetre of water. No intestinal bacilli. Proteus vulgaris pre-sent.
This is better water than the sample sent September 25,
but is not considered above suspicion.
Yours truly.
W. T. PATE.
DURHAM.
Dt'RHAM, N. (J., September 5, 1896.
Dr. J. M. Manning, Superintendent of Health.
Dear Sir:—In making a quantitative examination of the
sample of water collected and sent me by you on September 2,
1896. I have the honor to submit the following report : A quan-
SIXTH BIENNIAL RIOPORT. 67
titutive analysiis shows 128 colonies to the cubic centimetre.
This nuiuber indicates that tlie water is good, if all the bacteria
are of benign form, and I have no reason to doubt that they are,
from the tests used. Respectfullj' submitted,
Duplicate. ALBERT ANDERSON.
FAYETTEVILLE.
REPORT OF BACTERIOLOGICAL EXAMINATION.
Gibson Station, N. C, Nov. 10, 1896.
Dr. Leiois. Secretary North Carolina Board of Health,
Raleigh, N. C.
Dear Doctor :—As requested by you about October 1, 1 visited
Fayetteville October 27, and collected a sample of water from the
public water supply for examination. I called at the ofBce of
Superintendent of Health twice during the day, but did not find
him in. Dr. McNeill kindly took me out to the water works pond
and placed me under obligation to him for many favors.
Fayetteville has the possibilities of an ideal water supply. The
source is a bold sand hill branch, rising from springs among
the hills in the woods, flowing (without any surrounding
swamp) over a coarse sand and gravelly bed to a short
pond one and a-half miles northwest from the town. From
the pond it is pumped through iron pipes to the town.
The stand-pipe is on the summit of a hill (" Haymount "')
and gives a full pressure. The water shed proper is narrow and
short, has a sandy soil, timbered with scrubby oak and a few old-field
pine, and covered with tra^h that has drifted into heaps in
many places. There are four houses on the water shed, two
cabins, one farm house and the keeper's house. Stock have free
access to the pond. I noticed tlie droppings of cattle within
thirty feet of the intake.
With the expenditure of a small amount this water supply could
be placed above suspicion. It would be necess